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Abstract #27915 Published in IGR 13-1
Rare case of allergic blepharoconjuctivitis due to dorsolamide eyedrops
Urbancek S; Hazuchova HContact Dermatitis 2010; 63 SUPPL. 1 (65-66
Background: Topical anti-glaucomatics is heterogeneous chemical group of drugs consisting from five main chemical subgroups: beta-blockers, alpha-2 adrenergic agonists, prostaglandin derivates, cholinergic drugs and carbonic anhydrase inhibitors. They are very rare source of allergic contact dermatitis. Objectives: Description of clinical manifestation of topical antiglaucomatic drug. Methods: Authors describe rare case of allergic blepharoconjunctivitis due to dorsolamide, the carbonic anhydrase inhibitor. Results: Case report. A 58-year-old female patient with bilateral glaucoma has been treated by topical dorsolamide eyedrops (Trusopt(registered trademark), MSD, France) for 2 years. About 2 months ago marginal blepharitis associated with conjunctivitis has appeared. A previous dermatologic exam has concluded ocular rosacea and irritant dermatits, respctively. Topica treatment with momethasone ointment had partial effect, disease do not react at all to topical metronidazole, and fucidic acid.At the initial visit significant marginal blepharitis and conjunctivitis has been present. Patient note the significant impact on everyday functioning. Trolab(registered trademark) patch tests with European standard set, antimicrobials, vehicles and emulsifiers and ophthalmic battery were negative. Serial dilutions of Trusopt(registered trademark) eyedrops 1-10-50% and as is has been tested. There was a positive reaction to the concentration 10% and more after 48-72 hours. Withdrawal of Trusopt and replacement to prostaglandin derivate Xalatan(registered trademark) lead to rapid disappearance of the lesions. Conclusion: Authors describe very rare case of contact allergy to dorsolamide developing several months after the start of the treatment. Until now, there were only few anecdotic reports concerning allergic contact dermatitis to this drug. Exclusion of allergy to additives in eyedrops is necessary. Authors stress the fact, that clinically clear disease may be misdiagnosed. Allergenic potential of other groups of anti-glaucomatics is discussed.
S. Urbancek. Dermatology, F.D. Roosevelt Hospital, Banska Bystrica, Slovakia.
Classification:
11.5.2 Topical (Part of: 11 Medical treatment > 11.5 Carbonic anhydrase inhibitors)
2.1 Conjunctiva (Part of: 2 Anatomical structures in glaucoma)
11.16 Vehicles, delivery systems, pharmacokinetics, formulation (Part of: 11 Medical treatment)