Contact nonsteroidal antiinflammatory

Type III reactions are caused by tissue injury due to immune complexes. The antigen-antibody complexes are usually cleared by the immune system however, repeated contact with antigens can cause the complex to deposit in tissue and result in tissue injury. Serum sickness is the classic example of a Type III reaction. Medications associated with serum sickness include many antibiotics, phenytoin, salicylates, barbiturates, nonsteroidal antiinflammatory drugs, isoniazid, antisera, hydralazine, captopril, and sulfonamides. Procainamide-induced lupus, described in Chapter 16, is also considered a Type III reaction. 

Ophaswongse S, Maibach H. Topical nonsteroidal antiinflammatory drugs allergic and photoallergic contact dermatitis and phototoxicity. Contact Dermatitis 1993 29(2) 57-64. 

Bufexamac (p-butoxyphenylacethydroxyamic acid) is another nonsteroidal antiinflammatory drug used topically. Smeenk (1973) and Lachapelle (1975) described five cases of contact allergy. 

Walker SL, Ead RD, Beck MH. Occupational photoallergic contact dermatitis in a pharmaceutical worker manufacturing carprofen, a canine nonsteroidal antiinflammatory drug. Br J Dermatol 2006 154(3) 569-70. 

---