A transdermal patch of trouble

<p>A 79-year-old man, with a history of penicillin allergy, hypertension, diabetes mellitus, and multiple vertebral fractures secondary to severe osteoporosis, developed a pruritic, erythematous reaction limited to the site of application of transdermal buprenorphine.</p> <p>He had been applying transdermal buprenorphine patches for several weeks for chronic back pain before the lesions developed. After withdrawal of the transdermal buprenorphine and the use of topical high-potency corticosteroids, the lesions resolved. Skin patch tests with transdermal buprenorphine showed a papular erythematous reaction, suggesting a delayed hypersensitivity reaction.</p>