Insights into Proton Pump Inhibitor-induced photosensitivity: An observational study in a tertiary photobiology service

Sanaa Butt (Lead / Corresponding author), Alexandra McMullan, Robert Dawe, Sally Ibbotson

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Abstract

Background: Proton pump inhibitors (PPIs) are extensively prescribed but may cause photosensitivity and drug-induced lupus erythematosus (DILE), which can be overlooked as the drug may have been taken for years prior to presentation.

Methods: We reviewed the clinical and investigation findings of patients diagnosed with PPI-induced photosensitivity, diagnosed through the Scottish Photobiology Service.

Results: We report 11 patients with median age of onset 61-years and mean duration of PPI ingestion of 5-years [DILE (n = 6), phototoxicity (n = 3) and drug-induced solar urticaria through a lupus mechanism (n = 2)]. Five had Anti-Ro antibodies (three also ANA positive). Predominantly UVA and visible light photosensitivity was observed on phototesting.

Discussion: PPIs are a reversible cause of photosensitivity and DILE. Time to onset from drug initiation to symptoms can be prolonged, so clinicians should have a high index of suspicion in those taking PPIs. Most are diagnosed through clinical assessment and lupus serology, with phototesting indicated if there is diagnostic uncertainty.

Original languageEnglish
Pages (from-to)287-291
Number of pages5
JournalJournal of the Royal College of Physicians of Edinburgh
Volume52
Issue number4
Early online date25 Oct 2022
DOIs
Publication statusPublished - Dec 2022

Keywords

  • proton pump inhibitor
  • photosensitivity
  • phototoxicity
  • lupus
  • phototesting
  • Ro antibodies

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