Systemic contact dermatitis from subcutaneous hydromorphone

Abstract

We report a patient who developed a generalized dermatitis after a period of progressive local intolerance to continuous subcutaneous infusion of hydromorphone for cancer pain. Sensitization to hydromorphone was proved by a positive patch test. Infusions with an equianalgesic dose of diacetylmorphine were well tolerated, without local or systemic side-effects, and prolonged the duration of infusion sites.

Generalized dermatitis due to codeine. Cross‐sensitization among opium alkaloids

“…Pruritus and urticaria usually are caused by non‐immunological induction of histamine release, but codeine has also been related to maculopapular eruptions, angioneurotic oedema, fixed drug eruption, bullous eruption, multiform erythema, erythema nodosum, scarlatiniform rashes, or toxic epidermal necrolysis (2). Contact dermatitis from opium derivatives in pharmaceutical workers, nurses and doctors has also been described previously (3).…”

Morphine‐induced cutaneous adverse drug reaction following occupational diacetylmorphine contact dermatitis: A case report

“…Contact dermatitis and AGEP caused by diacetylmorphine and morphine have been reported before . Furthermore, the chemical similarities between morphine, diacetylmorphine and codeine are well known . Thyssen and Maibach, along with Schnyder and Pichler, reviewed the possible pathomechanisms of systemic allergic dermatitis .…”

“…[1][2][3][4][5][6] Furthermore, the chemical similarities between morphine, diacetylmorphine and codeine are well known. 9 Thyssen and Maibach, along with Schnyder and Pichler, reviewed the possible pathomechanisms of systemic allergic dermatitis. 10,11 The exact mechanism remains unclear.…”

Occupational contact dermatitis from diacetylmorphine (heroin)

“…Contact dermatitis from opium derivatives has been documented: occupationally in pharmaceutical workers (1) and in patients from treatment (2, 3). Diacetylmorphine (heroin), morphine and codeine have structural similarities: for an overview see De Cuyper & Goeteyn (2). The above‐mentioned opium derivatives are known for their histamine‐liberating effect, causing (non‐immunological) contact urticaria.…”