A 35-year-old male presented to the Department of Allergy with complaint of a progressive rash on his flank. Medical History: Four days before the rash, the patient was initiated on a smoking cessation program that utilized transdermal nicotine patches. Two days after initiation, a rash was observed, and the nicotine patches were discontinued. In addition, the patient was also treated for Group A Streptococcus throat infection, which was diagnosed one week prior. Medical Examination: The rash was approximately 20 cm ×10 cm and erythematous, well-demarcated, and papular.
A topical steroid with medium potency was prescribed to the patient. However, the rash worsened and was observed in other regions of the body (Image 1). Image 1. Rash observed at the application area of nicotine patch Laboratory Investigation: Patch testing conducted on unaffected areas of the skin was negative to three…
