Photosensitivity from nalidixic acid*

Abstract

SUMMARY Seven patients with a bullous photodermatitis from nalidixic acid are described. Bullae develop characteristically on the dorsal aspects of the feet and on the lower legs, but also elsewhere, in patients taking the drug who are exposed to a high level of ambient sunlight. At times, the clinical picture may be confused with porphyria cutanea tarda. Abnormal reactions to sunlight may continue for several months after the acute stage, whether or not the drug is stopped, but some patients may continue to take the drug if direct sunlight on the skin is avoided. Investigations showed that long wave ultraviolet radiation appears to be responsible for the reaction and it proved possible to induce photosensitivity in three volunteers who took the drug for I week. The Honorary Editors of The Proceedings of the Royal Society of Medians kindly gave permission for details in the abridged version of this paper to be published.

Important role of oxygen metabolites in quinolone antibacterial agent-induced cutaneous phototoxicity in mice

“…Of the quinolone derivatives, nalidixic acid (NA) is a known photosensitizer (Ramsay and obreshfova 1974;Epstein and Wintroub 1985); and is the first quinolone derivative to be used clinically in chemotherapy, as well as being the starting compound in development of newer quinolones such as ofloxacin (OFLX), lomefloxacin Offprint requests to: Nobuhiko Wagai (LMFX) and DR-3355 (the s-isomer of OFLX). Recently, some cases of photosensitivity due to enoxacin (ENX) and ciprofloxacin (CPFX) were reported (Smith et al 1986;Kawabe et al 1987;Matsui et al 1987).…”

Demonstration of Quinolone Phototoxicity in vitro

“…The action spectrum of nalidixic acid phototoxicity has been found to lie in the UVA region [8.13.24,26.27], and the results presented here are in good accordance with this. Additional reactivity to UVB has been reported in a photo-induced drug eruption due to nalidixic acid [10].…”

Pseudoporphyria due to Naproxen:A cluster of 3 cases

“…One of our-cases (case 2) dif fers from other cases in the literature as skin lesions healed while naproxen was still being administered, but patient had started to use a sunfilter. One case of pseudoporphyria due to nalidix acid behaved similarly (10). No porphyrin screen was done in case 3, but the causal relation with discontinuation of naproxen and subsiding of characteristic skin lesions confirm the diagnosis.…”