CASE REPORT

Psoriasis is a chronic inflammatory skin condition, which is often treated with topical corticosteroids and various topical non-steroidal medications. Tapinarof, a novel therapeutic agent, has shown promising results in the treatment of psoriasis. We report a case of contact allergy to tapinarof.

A 55-year-old female presented with a 10-year history of skin lesions on the superior aspect of the intergluteal cleft, diagnosed as psoriasis. The patient had been managing her symptoms with various topical treatments. After starting tapinarof cream (Vtama) (Dermavant Sciences Inc., Long Beach, CA), her rash began worsening and then spread for the first time to the perineum and genital area over the next few days.

Patch tests were performed using the 90 allergen 2021 American Contact Dermatitis Society (ACDS) core series and Vtama. IQ ultra chambers (Chemotechnique, Vellinge, Sweden) were applied to the patient's back for 2 days and read at both day 2 and day 4.

There was a 1+ reaction to Vtama at day 2, which increased to a 3+ reaction at day 4 (i.e., a crescendo reaction). All other allergens tested were negative. At day 2, there was no oedema, crusting or epidermal disruption at the patch test site (Figure 1). At day 4, oedema exceeded half of the patch test site. There was no crusting or epidermal disruption after the final reading (Figure 2) and none developed thereafter.

The vehicle of Vtama was obtained and patch testing yielded negative results at day 2 and day 4, confirming that the reaction to Vtama was due to tapinarof. Patch testing to half-strength Vtama was negative at day 2; however, there was a strong 3+ reaction at day 4. Twenty five control patients tested negative to 1% tapinarof cream at days 2 and 4.

中文翻译：

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病例报告：对 Tapinarof 接触性过敏

案例报告

牛皮癣是一种慢性炎症性皮肤病，通常用外用皮质类固醇和各种外用非类固醇药物治疗。Tapinarof 是一种新型治疗剂，在治疗牛皮癣方面显示出有希望的结果。我们报告了一例对塔皮那洛夫接触过敏的病例。

一名 55 岁女性，臀间裂上部皮肤病变已有 10 年病史，诊断为牛皮癣。该患者一直在通过各种局部治疗来控制她的症状。开始使用塔皮那罗夫霜 (Vtama)（Dermavant Sciences Inc.，长滩，加利福尼亚州）后，她的皮疹开始恶化，然后在接下来的几天里首次扩散到会阴和生殖器区域。

使用 90 种过敏原 2021 年美国接触性皮炎协会 (ACDS) 核心系列和 Vtama 进行斑贴测试。将 IQ 超腔室（Chemotechnique，Vellinge，瑞典）应用于患者背部 2 天，并在第 2 天和第 4 天进行读数。

第 2 天对 Vtama 出现 1+ 反应，第 4 天增加至 3+ 反应（即渐强反应）。所有其他过敏原测试均为阴性。第 2 天，斑贴测试部位没有出现水肿、结痂或表皮破裂（图 1）。第 4 天，水肿超过斑贴测试部位的一半。最终读数后没有结痂或表皮破裂（图 2），此后也没有出现任何情况。

获得 Vtama 载体，第 2 天和第 4 天的斑贴测试得出阴性结果，证实对 Vtama 的反应是由 Tapinarof 引起的。第 2 天，半强度 Vtama 的斑贴测试呈阴性；然而，第 4 天出现强烈的 3+ 反应。第 2 天和第 4 天，25 名对照患者对 1% 塔皮那洛夫乳膏的检测结果呈阴性。