A 55-year-old woman with high blood pressure and COPD was taking enalapril for her blood pressure and using formoterol inhaler for her lungs. She smoked about 10 cigarettes daily. When her lung symptoms worsened, her pulmonologist switched her inhaler to a combination of indacaterol and glycopyrronium.

Just two days after starting the new inhaler, she developed painful red patches on her face and neck along with a mild fever. She reported no new skincare products, diet changes, or recent illnesses that could explain the reaction. Although she had been in the sun, she had used proper sun protection.

Due to the sudden rash, doctors referred her urgently to dermatology. The dermatologist advised stopping the new inhaler immediately. A skin biopsy and blood tests were ordered to investigate the cause of the rash.

In addition, she was prescribed steroid pills to reduce inflammation and manage her symptoms. The steroids worked quickly—within 24 to 48 hours, the pain eased and the redness began to fade.

This case highlights the importance of monitoring for skin reactions after changing medications, especially inhalers, as they can sometimes cause allergic or inflammatory responses. Early dermatology consultation and timely treatment can lead to rapid improvement and prevent further complications.