Pacheco MM, Montero VD, Abarca BI

Language: Spanish
References: 15
Page:
PDF size: 152.03 Kb.

ABSTRACT

Drug-induced photosensitivity refers to skin rashes resulting from an exaggerated or abnormal response of the skin following exposure to ultraviolet (UV) radiation, either from sunlight or an artificial source, in patients using any drug. medicine. These can be subdivided into phototoxic and photoallergic reactions. The phototoxicity reaction is given by a non-immunological response that results in cell injury and tissue damage, while the photoallergic reaction corresponds to a delayed type IV hypersensitivity immunological reaction. Medications most commonly associated with these reactions include amiodarone, chlorpromazine, doxycycline, hydrochlorothiazide, naproxen, piroxicam, tetracyclines, voriconazole, griseofulvin, quinolones, sulfonamides, nonsteroidal anti-inflammatory drugs (NSAIDs) and systemic retinoids. The presentation of the reaction will depend on the dose of the drugs, as well as the time of exposure to UV radiation. Diagnosis is mainly based on a detailed clinical history and physical examination, although various methods such as phototesting or photopatch may be useful. Most can be treated with cold compresses, emollients or topical calamine, however, depending on the case, oral analgesics and topical corticosteroids may be needed. If the involvement is severe, systemic corticosteroids can be used.

REFERENCES

1. Montgomery S, Worswick S. Photosensitizing drug reactions. Clin Dermatol [Internet]. 2021. Doi: http://dx.doi.org/10.1016/j.clindermatol.2021.08.014

2. Monteiro AF, Rato M, Martins C. Drug-induced photosensitivity: Photoallergic and phototoxic reactions. Clin Dermatol [Internet]. 2016;34(5):571–81. Doi: http://dx.doi.org/10.1016/j.clindermatol.2016.05.006

3. Mora RM, Diego L, Sabaté LR. Fotosensibilidad inducida por fármacos. FMC - Form Médica Contin Aten Primaria [Internet]. 2021;28(6):357–70. Doi: http://dx.doi.org/10.1016/j.fmc.2021.02.006

4. Blakely KM, Drucker AM, Rosen CF. Drug-induced photosensitivity-an update: Culprit drugs, prevention and management. Drug Saf [Internet]. 2019;42(7):827–47. Doi: http://dx.doi.org/10.1007/s40264-019-00806-5

5. Ioele G, De Luca M, Garofalo A, Ragno G. Photosensitive drugs: a review on their photoprotection by liposomes and cyclodextrins. Drug Deliv [Internet]. 2017;24(2):33–44. Doi: http://dx.doi.org/10.1080/10717544.2017.1386733

6. Hofmann GA, Weber B. Drug-induced photosensitivity: culprit drugs, potential mechanisms and clinical consequences. J Dtsch Dermatol Ges [Internet]. 2021;19(1):19–29. Doi: http://dx.doi.org/10.1111/ddg.14314

7. Drug-induced photosensitivity [Internet]. Medscape.com. 2021 [cited Feb 13, 2022]. Available from: https://emedicine.medscape.com/article/1049648-overview

8. Odorici G, Monfrecola G, Bettoli V. Tetracyclines and photosensitive skin reactions: A narrative review. Dermatol Ther [Internet]. 2021;34(4). Doi: http://dx.doi.org/10.1111/dth.14978

9. Bolognia JL, Schaffer JV, Cerroni L, editores. Dermatolog a. 4a ed. Elsevier; 2018.

10. Ibbotson S. Drug and chemical induced photosensitivity from a clinical perspective. Photochem Photobiol Sci [Internet]. 2018;17(12):1885–903. Doi: http://dx.doi.org/10.1039/c8pp00011e

11. Lugović-Mihić L, Duvančić T, Ferček I, Vuković P, Japundžić I, Ćesić D. Drug-induced photosensitivity - a continuing diagnostic challenge. Acta Clin Croat [Internet]. 2017;56(2):277–83. Doi: http://dx.doi.org/10.20471/acc.2017.56.02.11

12. Balakirski G, Merk HF. Cutaneous allergic drug reactions: update on pathophysiology, diagnostic procedures and differential diagnosic. Cutan Ocul Toxicol [Internet]. 2017;36(4):307–16. Doi: http://dx.doi.org/10.1080/15569527.2017.1319379

13. Pan P, Svirskis D, Rees SWP, Barker D, Waterhouse GIN, Wu Z. Photosensitive drug delivery systems for cancer therapy: Mechanisms and applications. J Control Release [Internet]. 2021;338:446–61. Doi: http://dx.doi.org/10.1016/j.jconrel.2021.08.053

14. Ethinylestradiol/levonorgestrel: Phototoxic reaction: case report. React Wkly [Internet]. 2018;1709(1):97–97. Doi: http://dx.doi.org/10.1007/s40278-018-48508-8

15. Coelho L, Almeida IF, Sousa Lobo JM, Sousa e Silva JP. Photostabilization strategies of photosensitive drugs. Int J Pharm [Internet]. 2018;541(1–2):19–25. Doi: http://dx.doi.org/10.1016/j.ijpharm.2018.02.012