Medication changes are often necessary in patients with chronic illnesses, yet they can sometimes lead to unexpected and potentially serious side effects.

This case involves a 55-year-old woman with long-standing hypertension and chronic obstructive pulmonary disease (COPD), who developed an acute skin reaction shortly after switching her inhaler. The episode underlines the importance of vigilance, timely recognition of adverse reactions, and prompt intervention.

The patient had been managing her blood pressure with enalapril, an angiotensin-converting enzyme (ACE) inhibitor, and her COPD with a formoterol inhaler, a long-acting beta-agonist (LABA). Despite these treatments, her lung symptoms gradually worsened, particularly shortness of breath and episodes of wheezing. She also had a history of smoking around 10 cigarettes daily, which likely contributed to the progression of her respiratory disease.