Systemic contact dermatitis due to captopril without cross-sensitivity to fosinopril, quinapril and benazepril.

Sir, Angiotensin-converting enzyme (ACE) inhibitors are the most frequently prescribed antihypertensive drugs. Their effects on both hypertension and heart failure are highly beneficial. However, one has to be aware of the potential side effects, approximately 50% occurring in the skin. While angioedema is a well-known adverse cutaneous reaction to ACE inhibitors, other skin reactions are uncommon (1). We report the case of a patient with systemic contact dermatitis due to oral intake of the ACE inhibitor captopril. Previous reports and our data support the hypothesis that, while immune sensitivity to ACE inhibitors is a rare event, captopril is capable of eliciting delayed type hypersensitivity reactions in some patients.