Baççıoğlu, AyseKalpaklıoğlu, Ayşe FüsunDevrim, Tuba2025-01-212025-01-2120202147-2475https://doi.org/10.5505/respircase.2020.99267https://search.trdizin.gov.tr/tr/yayin/detay/409804https://hdl.handle.net/20.500.12587/22348Ultraviolet recall is a photodermatitis reaction that can occur in prior ultraviolet burned skin during the administration of systemic medication. No such reaction has been reported with pirfenidone. We report here on a 75-year-male patient who developed acute erosive erythema on his face, forearms and hands under pirfenidone treatment for idiopathic pulmonary fibrosis after 4 months. The initial diagnosis was drug eruption, since it developed after the initiation of pirfenidone, in accordance with hypereosinophilia and solar dermatitis on a skin biopsy, all of which improved with discontinuation. However, the patient tolerated the rechallange test with pirfenidone. The presence of necrotic keratinocytes in a skin biopsy and exaggerated dermatitis was unlikely for photo dermatitis, but supported an ultraviolet recall reaction. Pirfenidone was resumed in a tapered dose, and the patient was successfully followed up for 5 months for a relapse of skin reaction, as well as IPF disease activity. This case is important in indicating that the drug can be tolerated with dose adjustment in the presence of an ultraviolet recall reaction in contrast to discontinuation need in drug allergy.eninfo:eu-repo/semantics/openAccessDermatolojiArticle92798210.5505/respircase.2020.99267409804