Occupational contact dermatitis from piroxicam

Contact and photocontact dermatitis to piroxicam started being identified as coinciding with the use of this nonsteroidal anti-inflammatory drug as a topical medicament; until now, case reports are scarce in the literature. A 30-year-old woman, employed as a physical therapist, presented with chronic hand dermatitis. Patch testing and a visit to her place of work confirmed occupational exposure and sensitivity to piroxicam gel. She was also positive to thimerosal and nickel; avoidance of contact with this specific gel resulted in clearing of the dermatitis. Previous sensitization to thimerosal due to the thiosalicylic fraction may constitute a risk for developing piroxicam allergic contact dermatitis because of a cross-reaction phenomena.