Drug-Induced Photosensitivity

TY - CHAP

T1 - Drug-Induced Photosensitivity

AU - Ibbotson, Sally H.

N1 - Publisher Copyright: © Springer Nature Switzerland AG 2022.

PY - 2022/10/28

Y1 - 2022/10/28

N2 - Drug-induced photosensitivity is relatively common as most drugs absorb light and, theoretically, may cause abnormal photosensitivity. Most systemic drugs photosensitise through a non-immunological phototoxic mechanism that will occur in anyone exposed to enough drug and light of the appropriate wavelengths. Common culprits for systemic drug phototoxicity are thiazides, fluoroquinolones, doxycycline, non-steroidal anti-inflammatory drugs (NSAIDs), quinine and amiodarone. In contrast, photoallergy is much less common, is poorly defined for systemic drugs and is seen most frequently with topical sunscreen chemicals and topical NSAIDs. Clinical presentation of drug photosensitivity includes an immediate burning sensation on sun exposure, exaggerated sunburn or delayed erythema. For patients who are referred to a specialist photodiagnostic centre the gold standard investigation is monochromator phototesting on suspected drug, which typically shows either isolated UVA or disproportionate UVA photosensitivity, allowing this to be distinguished from other photodiagnoses, such as chronic actinic dermatitis. Monochromator phototesting is also used as part of photosafety evaluation of drugs under development in order to identify whether they have a significant phototoxic risk in healthy volunteer-based studies. The investigation of choice for topical photoallergy is photopatch testing. Accurate diagnosis is essential as drug-induced phototoxicity should reverse after drug cessation.

AB - Drug-induced photosensitivity is relatively common as most drugs absorb light and, theoretically, may cause abnormal photosensitivity. Most systemic drugs photosensitise through a non-immunological phototoxic mechanism that will occur in anyone exposed to enough drug and light of the appropriate wavelengths. Common culprits for systemic drug phototoxicity are thiazides, fluoroquinolones, doxycycline, non-steroidal anti-inflammatory drugs (NSAIDs), quinine and amiodarone. In contrast, photoallergy is much less common, is poorly defined for systemic drugs and is seen most frequently with topical sunscreen chemicals and topical NSAIDs. Clinical presentation of drug photosensitivity includes an immediate burning sensation on sun exposure, exaggerated sunburn or delayed erythema. For patients who are referred to a specialist photodiagnostic centre the gold standard investigation is monochromator phototesting on suspected drug, which typically shows either isolated UVA or disproportionate UVA photosensitivity, allowing this to be distinguished from other photodiagnoses, such as chronic actinic dermatitis. Monochromator phototesting is also used as part of photosafety evaluation of drugs under development in order to identify whether they have a significant phototoxic risk in healthy volunteer-based studies. The investigation of choice for topical photoallergy is photopatch testing. Accurate diagnosis is essential as drug-induced phototoxicity should reverse after drug cessation.

KW - Chemical

KW - Drug

KW - Photosafety

KW - Photosensitivity

KW - Phototoxicity

UR - https://www.scopus.com/pages/publications/105033174560

U2 - 10.1007/978-3-031-09388-3_17

DO - 10.1007/978-3-031-09388-3_17

M3 - Chapter

AN - SCOPUS:105033174560

SN - 9783031093876

SN - 9783031093906

T3 - Updates in Clinical Dermatology

SP - 203

EP - 210

BT - Drug Eruptions

A2 - Lee, Haur Yeuh

A2 - Creamer, Daniel

PB - Springer International Publishing

CY - Cham

ER -