ABSTRACT
Three women aged 73 to 77 years developed acute eczema of the upper and lower eyelids 24 hours after intravitreal injections containing aflibercept or ranibizumab, where azithromycin eye drops were used to prevent infection. The patient had applied eye drops with azithromycin dehydrate 15 mg/g recently for the second time, denying any worsening after the first application a year before. Patch tests were positive to the eye drops, and to azithromycin 1%, 5% and 10% pet. Patch tests were positive to the eye drops and to azithromycin 1%, 5% and 10% pet., but negative to the other ophthalmic, to erythromycin and clarithromycin. Cutaneous adverse drug reactions from systemic administration of azithromycin caused by type IV (delayed-type) hypersensitivity and occupational allergic contact dermatitis are planned to be discussed in Volume IV of the Monographs in Contact Allergy series on Systemic drugs.
