由大部分藥物引起的皮膚不良反應症狀是輕微的且停藥後即可緩解，但少部分的皮膚不良反應嚴重時可能有致命的危險。本案例為一名54歲女性因類風濕性關節炎導致雙腳關節腫脹變形造成的疼痛，不良於行服用Ultracet®和etoricoxib止痛。病人服用藥物4-5天後，發現手腳及臉部出現疹子，這些疹子看起來紅腫，長疹子的部位覺得熱熱的，疹子有的呈現水泡狀，有些還有化膿的情形。另外，醫師發現此病人患部發生蜂窩性組織炎，因此懷疑是皮膚過敏反應所間接造成的感染。病人經過適當的治療後，患部不再紅腫熱痛，狀況改善。藥師將此案例通報於院內及全國藥物不良反應通報系統。病人可能發生不良反應的藥物亦記載於紙本及電子病歷中，以期提昇病患用藥安全。

諸如此案例報告中發生蜂窩性組織炎的高危險群病患，這類看似輕微的皮膚不良反應卻有可能演變成嚴重的併發症。因此，處理這類病人的用藥問題必須詳盡的確認其疾病及用藥史，以避免病人症狀惡化。

Cutaneous reactions are among the most frequent adverse reactions to drugs. Most are benign, but a few can be life-threatening. This is a case of 54-year-old woman with rheumatoid arthritis who was treated with Ultracet® and etoricoxib. After 4-5 days of therapy, the patient was reported having rashes and blisters on her face, hands and legs. Also, doctors suspected that she developed cellulitis associating with drug-related cutaneous reactions. After the appropriate therapeutic interventions, the skin reactions and cellulitis was much improved.
In order to enhance drug safety, we reported the case to Adverse Drug Reactions (ADRs) Reporting System in our hospital and National Reporting System of ADRs in Taiwan.