Cutaneous side effects to TTSs are common and can result in poor patient compliance. A review in Dermatitis summarises these.
Irritant Reactions to TTSs
Skin irritation is the most commonly reported cutaneous side effect among users of TTSs. The exact prevalence is unknown, but general "skin reactions" have been reported in up to 97% of patients.
Classic irritant reactions are sharply demarcated, are limited to the area of TTS application and quickly fade away after removal.
Allergic Contact Dermatitis to TTSs
Allergy to the active pharmaceutical agents, adhesives, and other components og TTs has been described. TTSs are ideally suited to produce sensitization because they simulate Kligman's maximization procedure with long-term occlusion and associated irritation. The prevalence of allergic contact dermatitis from TTSs is unknown.
Management of Cutaneous Reactions to TTSs
Management of cutaneous reactions includes rotation of application sites, TTS placement on the buttocks, trying alternate brands and a shorter duration of occlusion. Also pretreatment with topical corticosteroids has been advocated as methods.
Most patients are able to shift to oral medication after failing transdermal therapy.
A list of the TTS agents which can cause cutaneous reactions can be found in the original publication.
Reference: Musel, Andrea L. & Warshaw, Erin M. Cutaneous Reactions to Transdermal Therapeutic Systems. Dermatitis. 2006; 17(3):109-122. Accessed November 8th, 2007 at www.medscape.com
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