Meglitinides (repaglinide and nateglinide) are insulin secretagogues used to treat diabetes mellitus. We present a case of hypersensitivity reaction to repaglinide in a 61-year-old man who developed a maculopapular rash 5 days after treatment.
Skin prick tests including repaglinide (0.5 μg/mL) and patch tests (0.05% in pet and saline) were performed, and the results were negative.
A blind oral challenge test with repaglinide was performed and the therapeutic dose was subsequently taken at home every 24 hours for 7 days.
The result was positive with a delayed reaction at day 3. A punch biopsy of the skin lesions revealed drug-induced exanthema.
The clinical manifestations, the latency period, the reappearance of cutaneous lesions after rechallenge, and the histopathology report of the skin biopsy suggest a type IV mechanism.

Key words: Oral antidiabetic drugs. Exanthema. Meglitinides. Repaglinide.