High incidence of amiodarone-induced photosensitivity in North-west England.

Abstract

Amiodarone is a potent cardiac antiarrhythmic agent which has been used in Europe for more than a decade but which has only recently become available in Britain. Facial pigmentation and photosensitivity are well recognised side effects,'-4 but their incidence is disputed. We report the incidence of photosensitivity in a large group of patients receiving amiodarone at a regional cardiothoracic centre.

Amiodarone‐induced skin pigmentation and multiple basal‐cell carcinomas

“…Amiodarone induces photosensitivity in 30–57% of patients, 2,3 Phototoxic reactions occur at both UVA and UVB, to a lesser extent with the latter. Skin discoloration occurs in < 10% of cases 4 .…”

Photolysis of Amiodarone, an Antiarrhythmic Drug

“…This pigmentation was attributed to a granular accumulation of lipofuschin type pigment within dermal macrophages (Zachary eral., 1984;Trimble et af., 1983). This photosensitivity requires accumulation of the drug in the body and only appears from 2 weeks to 2 years after the start of the amiodarone therapy (Ljunggreen and Moller, 1978;Chalmers et al, 1982).…”

The pathogenesis of amiodarone-induced pigmentation and photosensitivity

“…Iodine-rich amiodarone and its metabolite have been detected in secondary lysosomes by energy dispersive analysis of X-rays. Amiodarone induces a phototoxic reaction with an action spectrum in both the UV-B and UV-A wavelengths.Amiodarone is a highly effective anti-dysrhythmic agent which also has anti-anginal properties (Singh & Vaughan-Williams, 1970; Coteer al., 1979; Marcus ^r a/., 1981), Photosensitivity is a common adverse reaction occurring in a high proportion of patients (Chalmers et al, 1982;Harris et al., 1983) and appears to be a dose-related phenomenon. A rarer problem is the occurrence in the light-exposed areas of blue-grey pigmentation.We have investigated the pathogenesis of these adverse effects, employing a combination of biochemical and histopathological techniques.…”

“…Amiodarone is a highly effective anti-dysrhythmic agent which also has anti-anginal properties (Singh & Vaughan-Williams, 1970;Coteer al., 1979;Marcus ^r a/., 1981), Photosensitivity is a common adverse reaction occurring in a high proportion of patients (Chalmers et al, 1982;Harris et al., 1983) and appears to be a dose-related phenomenon. A rarer problem is the occurrence in the light-exposed areas of blue-grey pigmentation.…”