Case of photosensitivity caused by fenofibrate after photosensitization to ketoprofen

Contribution of phototesting in the diagnosis of photodermatoses: Retrospective study of 100 cases

“…The patients sensitized to ketoprofen can react to sunscreens because of crossallergy between ketoprofen, tiaprofenic acid, octocrylene, and benzophenone 16,[26][27][28] . Other studies mentioned associated allergy with ketoprofen and with fenofibrate 29 . Ketoprofen is usually responsible for severe and bullous forms of PCD 9,16,27,28 .…”

Fenofibrate‐induced photosensitivity – a case series and literature review

“…The duration of drug intake to onset of skin eruptions ranges from three days to four weeks, and it seems to be later onset in Fitzpatrick skin phototype IV or V. However, more case numbers or furthers studies are needed to confirm this observation. A history of photocontact dermatitis to ketoprofen gel will accelerate the onset of fenofibrateinduced photosensitivity to days only (1,9).…”

“…The photosensitizing capacity of fenofibrate could be explained by the photoexcited chemical structure, the benzophenone (double benzene rings linked by a ketone group) (9). Among the fibric acid derivatives including fenofibrate, bezafibrate, clofibrate, and gemfibrozil, fenofibrate has the highest incidence of photosensitivity because of the benzophenone moiety (Fig.…”

Photopatch Testing

“…Other NSAIDs analogous to ketoprofendexketoprofen, piketoprofen, and ibuprofen -and diclofenac, now frequently used in the treatment of actinic keratosis with cases reported of PhACD [105,106], as well as chlorpromazine, responsible for recent cases of PhACD in caregivers [17,18], were proposed to be included in the extended series. Fenofibrate was also included, as positive photopatch tests confirm the diagnosis of systemic fenofibrate photosensitivity [33,107], but they also occur in the context of photoallergy to ketoprofen due a common benzophenone structure in these chemicals [108,49]. "Historical" photoallergens, like olaquindox a swine feed additive banned by the European Commission in 1998, and some halogenated salicylanilides, removed from disinfectants and hygiene products in most countries since 1976, which caused PhACD from "imported" products, are also recommended to include in an extended photopatch test tray [3] (Table 5).…”