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A rare and serious drug reaction recently drew urgent attention after a 55-year-old woman developed sudden, painful skin symptoms following a change in her respiratory medication. What initially seemed like a routine adjustment quickly became a significant dermatological emergency, highlighting the need for caution whenever new medications are introduced—even those commonly prescribed.

The patient had a history of hypertension and chronic obstructive pulmonary disease (COPD), both well-controlled with enalapril and formoterol for several years. Her health had been stable, with no recent hospitalizations, infections, or major lifestyle changes.

Problems began shortly after her inhaler regimen was switched. Her formoterol-based treatment was replaced with a combination inhaler containing indacaterol and glycopyrronium, long-acting bronchodilators commonly used in COPD. Soon after, she developed alarming symptoms that could not be ignored.

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