Phototoxicity from Systemic Agents

Toback, Arnold C.; Anders, Jeannette E.

doi:10.1016/s0733-8635(18)30825-8

Cited by 24 publications

(12 citation statements)

References 57 publications

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“…Phototoxic skin reactions are the most common form of drug‐induced photosensitivity and occur in minutes to hours after exposure to UV light. Phototoxicity is dose‐dependent, does not require prior sensitization, is localized to exposed skin only, and clinically resembles an exaggerated sunburn . On the other hand, photoallergic skin reactions are less common than phototoxic skin reactions, not dose‐dependent, require minimal exposure to light, develop 24 hours or more after initial exposure, require pre‐sensitization, present as eczematous dermatitis that may spread beyond UV‐exposed sites, and are immunologically mediated …”

Section: Discussionmentioning

confidence: 99%

“…Drug-induced photosensitivity is classified as either a phototoxic or photoallergic skin reaction, differentiated by the absence or presence, respectively, of an immunological basis to the reaction. 3 Phototoxic skin reactions are the most common form of drug-induced photosensitivity and occur in minutes to hours after exposure to UV light. Phototoxicity is dose-dependent, does not require prior sensitization, is localized to exposed skin only, and clinically resembles an exaggerated sunburn.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Hydrochlorothiazide‐induced photosensitivity in a psoriasis patient following exposure to narrow‐band ultraviolet B excimer therapy

Rosenthal

Herrmann

2019

Photoderm Photoimm Photomed

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Drug‐induced photosensitivity develops when the use of oral or topical photosensitizing medications creates a rash after exposure to ultraviolet (UV) radiation. Medications most commonly implicated in photosensitive drug reactions include amiodarone, nonsteroidal anti‐inflammatories, thiazides, tetracycline antibiotics, chlorpromazine, and fluoroquinolones. It is generally believed that drug‐induced photosensitivity is an UVA phenomenon, caused by UV wavelengths between 315 and 400 nm. Here, we present a case of hydrochlorothiazide (HCTZ)‐induced photosensitivity following exposure to 308‐nm narrow‐band (nb) UVB light emitted from an excimer laser in a patient undergoing treatment for plaque psoriasis. This patient had received biweekly treatments with the excimer laser for years prior without any history of adverse reactions. We believe that our patient suffered an acute photosensitivity to UVB due to new‐onset HCTZ. Because nb UVB–emitting lasers are used to treat many dermatologic conditions, physicians should be aware of potential photosensitivity reactions, review medication lists and counsel patients accordingly.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hydrochlorothiazide‐induced photosensitivity in a psoriasis patient following exposure to narrow‐band ultraviolet B excimer therapy

Rosenthal

Herrmann

2019

Photoderm Photoimm Photomed

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“…Phototoxicity occurs when the appropriate wavelength of light penetrates the skin where the photosensitizing drug or its metabolite is located. The photosensitizer absorbs the UVL energy, inducing oxygen radical formation, followed by cellular damage and an inflammatory response [7]. Pseudo-PCT represents a severe form of phototoxicity with bullae formation resembling PCT without associated elevated blood porphyrin levels (Patient 1) .…”

Section: Discussionmentioning

confidence: 99%

Voriconazole-Induced Phototoxicity Masquerading as Chronic Graft-versus-Host Disease of the Skin in Allogeneic Hematopoietic Cell Transplant Recipients

Patel

Turner

Baird

et al. 2009

Biology of Blood and Marrow Transplantation

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Systemic fungal infections pose a significant risk to patients following allogeneic hematopoietic cell transplantation (alloHCT). Voriconazole (Vfend®, Pfizer) is an oral second-generation triazole antifungal agent that offers broad spectrum of coverage against fungal species and is frequently utilized in the post-HCT setting. Herein, we describe five patients who were initially believed to be experiencing a flare of cutaneous chronic graft-versus-host disease (cGvHD), but who were actually exhibiting phototoxicity caused by voriconazole. A high index of suspicion for this adverse reaction in the post-alloHCT setting will prevent misdiagnosis and avoid inappropriate therapy for cGvHD.

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“…7,8 Phototoxicity Three separate steps have been identified in the mechanism by which drugs induce phototoxicity: The drug or an active metabolite must reach viable cells in the skin, light of the appropriate wavelength must penetrate the skin, and photons of light must be absorbed by the photosensitizing chemical. 2,9 Theoretically the reaction will occur during the first exposure in any person as long as sufficient concentrations of the chemical and proper light exposure have been attained.…”

Section: Photosensitization Mechanismmentioning

confidence: 99%