Mucosal exfoliation as a selective reaction to etoricoxib

What is known and objective: Etoricoxib is a non-steroidal anti-inflammatory drug (NSAID) that inhibits the inducible cyclooxygenase (COX-2) with a good safety profile. We describe the first case of two mucosal adverse events to etoricoxib in the same patient. Case description: Our patient developed stomatitis with mucosal exfoliation after etoricoxib assumption. Some months later, after a new etoricoxib intake, she presented with vaginal burning, tongue angioedema and erosions, oral exfoliation and wheals on the hands. A provocation test with diclofenac was negative. What is new and conclusion: The peculiarities of our case are the rare clinical manifestation and the selective hypersensitivity to COX-2 inhibitor with tolerance to a non-selective NSAID.