4-CLASSIFICATION
HSRs to PPIs may be immediate or non-immediate/delayed and vary from mild symptoms to life-threatening disorders, including urticaria, angioedema and anaphylaxis, maculopapular eruption, contact dermatitis (occupational), photoallergic dermatitis, erythroderma, drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome, Stevens-Johnson syndrome/Toxic epidermal necrolysis (SJS/TEN).27 Most reported reactions to PPIs are immediate HSRs3 and among them more than half are anaphylaxis.2,17-19,23,28 Most HSRs to PPIs occur in female (61%) and almost all cases are described in adults with a mean age of 46±13 years.29 One case report described anaphylaxis secondary to omeprazole in a 14-year-old boy30 and another anaphylaxis to omeprazole and pantoprazole in a 16-years old girl is also described.31