Evaluation of the frequency and intensity of favipiravir‐associated yellow‐green fluorescence in lunulae, hair, and face

Turan, Çağrı; Metin, Nurcan; Utlu, Zeynep; Yıldız, Türkan Tuğba; Sakat, Selcen Caferoğlu

doi:10.1111/jocd.14189

Cited by 5 publications

(17 citation statements)

References 22 publications

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“…The incidence of fluorescence in nails due to the use of favipiravir was previously reported as 81.9% and 84% [ 9 , 12 ]. Similar to the findings in these studies, we observed fluorescence in the nail in 90% of our patients using favipiravir, and we observed that there was fluorescence in the nail in 100% of the patients who received the full loading dose.…”

Section: Discussionmentioning

confidence: 99%

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Follow-up of Favipiravir-Induced Nail Fluorescence: Implications for Nail and Drugs

Güder

Özünal

2023

Dermatol Pract Concept

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Introduction: Favipiravir creates fluorescence on nails, which can be seen with Wood's light. Objectives: The objectives of this study are to examine the properties of fluorescence in the nail due to favipiravir and to observe whether other drugs also produce fluorescence in the nail. Methods: The research is descriptive, prospective, and quantitative. This study recruited 30 healthcare workers who received favipiravir treatment and 30 volunteers who took or did not take any medication except favipiravir from March 2021 to December 2021. Fingernails of the patients and control groups were examined under Wood's light in the darkroom. If fluorescence was observed in the fingernails, we followed up once a month until the fluorescence disappeared. We calculated the nail growth rate by dividing the distance of nail fluorescence from the proximal nail fold by the number of days since favipiravir was started. Results: We found nail fluorescence in all patients receiving a loading dose of favipiravir. The fluorescence in the nail decreased and disappeared in the 3rd month. The average nail growth rate at the first visit was 0.14 mm/day. The nail growth rate at the second visit was 0.10 mm/day. A statistically significant difference was found between the first and second visit nail growth rates (z: -2.576; p=0.010<0.05). We found that other drugs did not produce any fluorescence in the nail. Conclusions: Nail fluorescence induced by favipiravir is dose-dependent and decreases in intensity over time. Nail fluorescence due to favipiravir is likely due to the active ingredient of the drug.

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Section: Discussionmentioning

confidence: 99%

“…When examining a Wood's lamp in a dark room, fluorescence is seen if there are fluorophores [3]. So far, the following fluorescence has been reported in the nail due to drug use: yellow for tetracycline, yellow/green for quinacrine, and yellow/ green/blue fluorescence for favipiravir [4][5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Follow-up of Favipiravir-Induced Nail Fluorescence: Implications for Nail and Drugs

Güder

Özünal

2023

Dermatol Pract Concept

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“…8,11 In humans, favipiravir-related whitish to bluish nail fluorescence under Wood's light has been recognized during the COVID-19 era and documented in several published case series and controlled studies. 4,[6][7][8][9][10][11][12][13][14][15][16] In one study involving 174 patients diagnosed with COVID-19 infection within the last 100 days, nail fluorescence positivity rate was significantly higher in favipiravir-treated group compared to patients treated with other agents. 9 Nail fluorescence under Wood's lamp was encountered in 59 among 72 (81.9%) patients treated solely with favipiravir; and 47 among 56 (83.9%) patients treated with favipiravir and hydroxychloroquine combination.…”

Section: Nailsmentioning

confidence: 99%

“…Transient greenish hair fluorescence accountable to favipiravir has also been noted in published case series and a few studies. 7,8,10,11,16,19 It appears that there is no correlation between the dosage of favipiravir and the intensity of hair fluorescence under Wood's lamp. 16,19 In one study of 275 patients, nail and hair fluorescence positivity rates correlated with the cumulative dose of favipiravir, while fluorescence intensity was independent of the cumulative dose.…”

Section: Hairmentioning

confidence: 99%

Luminescence of favipiravir in skin appendages and sclera. A controlled study and literature review

Demircioğlu,

Durmaz

2023

Photoderm Photoimm Photomed

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Background/ObjectivesFavipiravir is an antiviral agent, recently used for COVID‐19 infections. Several reports associate favipiravir intake with Wood's lamp fluorescence of hair, nails, and sclera. The present study was designed to elucidate the positivity rates, and sites of favipiravir‐related fluorescence and to unravel the site‐specific changes in fluorescence positivity rates by a function of time past exposure.MethodsThe study population comprised 50 patients and 50 control individuals. All patients in the patient group had received a full dose of favipiravir for COVID‐19 infection. Fifty volunteers served as the control group. Wood's lamp examination was performed in a completely darkened room, and the positivity rate, extent, pattern, and distribution of fluorescence were recorded.ResultsWood's light revealed fluorescence of the fingernails, toenails, sclera, and hair in 35 (70%), 35 (70%), 22 (44%), and 8 (16%) patients, respectively. No control individual tested positive by Wood's lamp. Statistical analysis revealed significant differences between patient and control groups in terms of Wood's light luminescence in the fingernails (p = .000), toenails (p = .000), sclera (p = .000) and hair (p = .003). Although fingernail, toenail, and hair fluorescence positivity rates declined or ceased at or after 91 days of favipiravir exposure, ocular fluorescence positivity rates were prolonged up to 188 days.ConclusionsThese findings confirm that favipiravir may produce fluorescence of nails, sclera, and hair, detectable by Wood's light starting from the initial month and peaking at second‐ and third months following exposure to the medication. Although nail and hair fluorescence tend to abate after 3 months, ocular fluorescence may persist even longer than 6 months after cessation of the medication.

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“…It was reported that fluorescence may be a phototoxic side effect of favipiravir. 8 Since favipiravir is thought to be phototoxic, it may be necessary to avoid UV exposure during the period until the drug is eliminated from the body.…”

Section: Figurementioning

confidence: 99%

Wood's lamp examination of hair and nails related to COVID‐19 treatment

Demir

Çiçek

Turkoglu

et al. 2021

Dermatologic Therapy

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Dear Editor, Favipiravir, (6-fluoro-3-hydroxy-2-pyrazine carboxamide) the drug which is being used in the treatment of COVID-19 is a broadspectrum antiviral agent. The drug is converted to its active phosphorylated form in the cells, and it inhibits viral RNA polymerase activity. 1 The main organs that favipiravir being distributed are the lungs, kidneys, spleen, and brain. 2 Among the cutaneous side-

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Evaluation of the frequency and intensity of favipiravir‐associated yellow‐green fluorescence in lunulae, hair, and face

Cited by 5 publications

References 22 publications

Follow-up of Favipiravir-Induced Nail Fluorescence: Implications for Nail and Drugs

Follow-up of Favipiravir-Induced Nail Fluorescence: Implications for Nail and Drugs

Luminescence of favipiravir in skin appendages and sclera. A controlled study and literature review

Wood's lamp examination of hair and nails related to COVID‐19 treatment

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