Allergic contact dermatitis caused by rotigotine in a transdermal therapeutic system

Conflicts of interest: No conflict of interests. desquamation at the application sites of a rotigotine TTS (Neupro® 6 mg/24 h; UCB Pharma, France Colombes) for 3 months, with extension on the neckline and the upper back (Fig. 1). These reactions began 2 weeks after the patient had used this TTS for early signs of Parkinson’s disease, with a progressive increase in the dose of rotigotine (initial dose, 2 mg/24 h). The patient changed the application site every day, and did not apply the TTS to the same area of skin more often than once every 14 days, as recommended. Applications of Neupro® were stopped, and it was replaced with an oral non-ergolinic dopamine agonist, pramiprexole (Sifrol®), with good tolerance. Later, patch tests were carried out with European baseline series (Chemotechnique Diagnostics, Vellinge, Sweden), sodium metabisulfite present as excipient (2% pet.; Chemotechnique), the placebo TTS, and the pure drug rotigotine, the latter two materials being kindly provided