Lichenoid photodermatitis associated with nimesulide

An 81‐year‐old‐female patient presented with a 2 week history of erythematous to violaceous lichenoid papules and plaques exhibiting a reticulated pattern on the ‘‘V’' area of the chest and dorsal hands. Fine, whitish reticulated networks were present over the surface of many well developed papules. The lesions were sharply demarcated and moderately pruritic ( Fig. 1). 1 Violaceous lichenoid papules with reticular pattern located on the ‘‘V’' area of the chest The result of routine complete blood cell count, urinalysis, erythrocyte sedimentation rate, liver and kidney function tests were within normal limits. Antinuclear and anti‐DNA antibodies were negative, and total C3 and C4 complement levels were normal. Hepatitis B surface antigen, anti‐Hepatitis B surface antigen, anti‐Hepatitis B core IgM antibody were negative, while anti‐Hepatitis C virus antibody was positive. A skin biopsy specimen obtained from the neck of our patient revealed an interface lichenoid dermatitis accompanied by individual necrotic epidermal keratinocytes, parakeratosis and eosinophils in the infiltrate ( Fig. 2). 2 Interface lichenoid dermatitis accompanied by individual necrotic epidermal keratinocytes and parakeratosis (Hematoxylin and eosin; original magnification, × 200) Nimesulide therapy was stopped and the patient was treated with topical corticosteroids and systemic antihistamines. The eruption resolved within 5 days. The rash returned following nimesulide rechallenge.