Periorbital allergic contact dermatitis to ketotifen fumarate eyedrops

Abstract

Ketotifen fumarate (KF) is a widely used drug for prophylaxis and the treatment of allergic conditions. Adverse cutaneous reactions to KF are rare except for dryness of the skin and mouth. To the best of our knowledge, no case of allergic contact dermatitis to ketotifen fumarate has yet been reported in the Korean literature. A 60-year-old woman presented with pruritic erythematous patches on the periorbital area. She had used KF eyedrops (Ketoftil ophthalmic solution) for itchy eyes after cataract surgery, and the periorbital lesions developed four weeks later. The KF eyedrops contained not only KF (0.69 mg/ml) but also benzalkonium chloride (0.1 mg/ml). We performed patch tests with the Korean standard patch test series: KF (0.69 mg/ml, 0.069 mg/ml and 0.0069 mg/ml in aqueous solution), and benzalkonium chloride (0.1% in petrolatum). These patch tests showed weak positive reaction to KF (0.69 mg/ml and 0.069 mg/ml) and nickel sulfate, and a negative reaction to benzalkonium chloride. The skin lesions improved rapidly after stopping the eyedrops and applying a topical steroid. We herein report on a rare case of allergic contact dermatitis to ketotifen fumarate eyedrops.