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Toxicology Research Nov 2018Phototoxicity can cause toxic responses such as edemas and lesions, and is one of the severe adverse effects that largely limit the use of these phototoxic drugs. Some... (Review)
Review
Phototoxicity can cause toxic responses such as edemas and lesions, and is one of the severe adverse effects that largely limit the use of these phototoxic drugs. Some traditional Chinese medicines (TCMs) and their constituents have been reported to be phototoxic. However, to date, their phototoxicity information is still very limited, and lacks systemic investigation. This article presents the phototoxicity potential of various types of TCMs and their active components in an effort to provide valuable information for drug research and discovery to mitigate phototoxicity concerns. Some potential mechanisms of action (MoAs) of phototoxicity are discussed. In addition, and phototoxicity assays are summarized this review.
PubMed: 30542599
DOI: 10.1039/c8tx00141c -
Toxicology in Vitro : An International... Feb 2024Phototoxicity, sometimes in the literature referred to as photo-irritation, is a chemically induced reaction requiring light. While it is generally accepted that...
Phototoxicity, sometimes in the literature referred to as photo-irritation, is a chemically induced reaction requiring light. While it is generally accepted that phototoxicity testing can be performed in the majority of cases in vitro (i.e. without the use of experimental animals), these tests may sometimes provide contradictory predictions. Understanding the mechanisms of initiating events based on the molecule's structure and its ability to reach the excited state and consequently generate ROS enables the creation of predictive QSAR for this adverse outcome. The ability to predict the phototoxicity potential via a QSAR model is beneficial in reducing the number of mechanical in vitro/in chemico tests needed to demonstrate absence of phototoxicity and it is very helpful in the overall safety assessment process. The QSAR prediction model presented here focused on developing a robust platform freely available on the web via the link http://mltox.online to provide interpretable predictions of the phototoxicity of tested molecules. Great attention was devoted to interpretability and explainability of the prediction results. The web application allows the user to input a chemical by CAS number, SMILES code or trivial name. The user can choose between simple prediction or advanced tools options. These extended tools include the artificial intelligence explainability of model prediction using XSMILES (interactive visualization technique to support the interpretation of SMILES) and SHAP values (impact each element on the prediction). The comprehensive tools in question allow the user to explore the properties of phototoxic substances and to understand the prediction outcomes better.
Topics: Animals; Artificial Intelligence; Dermatitis, Phototoxic; Software
PubMed: 37820749
DOI: 10.1016/j.tiv.2023.105701 -
Clinics in Dermatology 2016Drug-induced photosensitivity refers to the development of cutaneous disease due to the interaction between a given chemical agent and sunlight. Photosensitivity... (Review)
Review
Drug-induced photosensitivity refers to the development of cutaneous disease due to the interaction between a given chemical agent and sunlight. Photosensitivity reactions can be classified as phototoxic or photoallergic. Sometimes, there is an overlap between these two patterns, making their distinction particularly difficult for the clinician. We review the drugs that have been implicated as photosensitizers, the involved mechanism, and their clinical presentations. The main topical agents that cause contact photosensitivity are the nonsteroidal antiinflammatory drugs, whereas the main systemic drugs inducing photosensitivity are antimicrobials, nonsteroidal antiinflammatory agents, and cardiovascular drugs. Drug-induced photosensitivity remains a common clinical problem and is often underdiagnosed.
Topics: Administration, Cutaneous; Administration, Oral; Anti-Arrhythmia Agents; Anti-Infective Agents; Anti-Inflammatory Agents, Non-Steroidal; Antihypertensive Agents; Antineoplastic Agents; Dermatitis, Photoallergic; Dermatitis, Phototoxic; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Psychotropic Drugs
PubMed: 27638435
DOI: 10.1016/j.clindermatol.2016.05.006 -
Acta Pharmaceutica Hungarica 2015The photosensitivity originated from drugs is a common problem in medical and pharmaceutical practice. It is of prominent importance in drug development and in... (Review)
Review
The photosensitivity originated from drugs is a common problem in medical and pharmaceutical practice. It is of prominent importance in drug development and in regulatory issues. The photosensitizer effect of drug substances is determined by their chemical structures, and it mainly originates from aromatic chromophore systems and photo-dissociable bonds forming free radicals. The photodegradation may happen in many different types of chemical reaction pathways. Our aim is to demonstrate in this review the interrelations between structure and photodegradation. We show examples for the different reaction types, with drugs from different pharmacologic therapeutic classes. The in vivo chemical reactivity of photodegradates of pharmaceutical substances, the in vitro methods of investigation for testing photoreactivity and phototoxicity, and briefly the clinical tests for photosensitivity disorders are also discussed.
Topics: Chemistry, Pharmaceutical; Dermatitis, Phototoxic; Humans; Photolysis; Photosensitivity Disorders; Photosensitizing Agents; Structure-Activity Relationship; Ultraviolet Rays
PubMed: 26390736
DOI: No ID Found -
Deutsches Arzteblatt International Mar 2020
Topics: Antimalarials; Dermatitis, Phototoxic; Doxycycline; Female; Humans; Young Adult
PubMed: 32343652
DOI: 10.3238/arztebl.2020.0196 -
Journal of Photochemistry and... Feb 2024Photosensitivity to structurally diverse drugs is a common but under-reported adverse cutaneous reaction and can be classified as phototoxic or photoallergic. Phototoxic...
Photosensitivity to structurally diverse drugs is a common but under-reported adverse cutaneous reaction and can be classified as phototoxic or photoallergic. Phototoxic reactions occur when the skin is exposed to sunlight after administering topical or systemic medications that exhibit photosensitizing activity. These reactions depend on the dose of medication, degree of exposure to ultraviolet light, type of ultraviolet light, and sufficient skin distribution volume. Accurate prediction of the incidence and phototoxic response severity is challenging due to a paucity of literature, suggesting that phototoxicity may be more frequent than reported. This paper reports an extensive literature review on phototoxic drugs; the review employed pre-determined search criteria that included meta-analyses, systematic reviews, literature reviews, and case reports freely available in full text. Additional reports were identified from reference sections that contributed to the understanding of phototoxicity. The following drugs and/or drug classes are discussed: amiodarone, voriconazole, chlorpromazine, doxycycline, fluoroquinolones, hydrochlorothiazide, nonsteroidal anti-inflammatory drugs, and vemurafenib. In reviewing phototoxic skin reactions, this review highlights drug molecular structures, their reactive pathways, and, as there is a growing association between photosensitizing drugs and the increasing incidence of skin cancer, the consequential long-term implications of photocarcinogenesis.
PubMed: 38389933
DOI: 10.1016/j.jpap.2023.100221 -
Journal of the American Academy of... Dec 2023Erythropoietic protoporphyria and X-linked protoporphyria are rare genetic photodermatoses. Limited expertise with these disorders among physicians leads to diagnostic...
Erythropoietic protoporphyria and X-linked protoporphyria are rare genetic photodermatoses. Limited expertise with these disorders among physicians leads to diagnostic delays. Here, we present evidence-based consensus guidelines for the diagnosis, monitoring, and management of erythropoietic protoporphyria and X-linked protoporphyria. A systematic literature review was conducted, and reviewed among subcommittees of experts, divided by topic. Consensus on guidelines was reached within each subcommittee and then among all members of the committee. The appropriate biochemical and genetic testing to establish the diagnosis is reviewed in addition to the interpretation of results. Prevention of symptoms, management of acute phototoxicity, and pharmacologic and nonpharmacologic treatment options are discussed. The importance of ongoing monitoring for liver disease, iron deficiency, and vitamin D deficiency is discussed with management guidance. Finally, management of pregnancy and surgery and the safety of other therapies are summarized. We emphasize that these are multisystemic disorders that require longitudinal monitoring. These guidelines provide a structure for evidence-based diagnosis and management for practicing physicians. Early diagnosis and management of these disorders are essential, particularly given the availability of new and emerging therapies.
Topics: Humans; Dermatitis, Phototoxic; Genetic Diseases, X-Linked; Liver Diseases; Protoporphyria, Erythropoietic; Practice Guidelines as Topic
PubMed: 36041558
DOI: 10.1016/j.jaad.2022.08.036 -
Der Hautarzt; Zeitschrift Fur... Jun 2015Methotrexate (MTX), alongside fumaric acid esters, is the most commonly used drug in the systemic therapy of psoriasis in Germany. It is sometimes used in combination...
BACKGROUND
Methotrexate (MTX), alongside fumaric acid esters, is the most commonly used drug in the systemic therapy of psoriasis in Germany. It is sometimes used in combination with topical therapy and/or phototherapy due to synergistic effects.
CASE REPORT
Here we describe a case of phototoxic dermatitis during treatment with MTX. Other cutaneous side effects of MTX include so-called UV recall, radiation recall, and skin tumor formation.
Topics: Adult; Arthritis, Psoriatic; Combined Modality Therapy; Humans; Male; Methotrexate; Neoplasms, Radiation-Induced; Photosensitivity Disorders; Psoriasis; Radiodermatitis; Risk Factors; Skin Neoplasms; Ultraviolet Therapy
PubMed: 25578302
DOI: 10.1007/s00105-014-3569-6 -
The Journal of Emergency Medicine Mar 2016
Topics: Citrus aurantiifolia; Dermatitis, Phototoxic; Fruit and Vegetable Juices; Hand Dermatoses; Humans; Male; Skin Diseases, Vesiculobullous; Young Adult
PubMed: 26803192
DOI: 10.1016/j.jemermed.2015.11.014 -
Bundesgesundheitsblatt,... Jun 2017Multiple environmental exposures may derange the regulatory and repair mechanisms of the skin and lead to dermatological disease. (Review)
Review
BACKGROUND
Multiple environmental exposures may derange the regulatory and repair mechanisms of the skin and lead to dermatological disease.
OBJECTIVES
Provide an overview of non-allergic skin diseases associated with environmental factors.
MATERIALS AND METHODS
Review of current scientific evidence for associations of non-allergic skin diseases with environmental exposures: irritation, chemicals, infection, UV-radiation, temperature.
RESULTS
Predisposition (constitution e. g. for atopic dermatitis, psoriasis and filaggrin gene mutations) and exposure (environment) are crucial for disease development or maintenance of health in an individual. Specific chemical and contagious agents lead to characteristic skin diseases (e. g. halogen acne) which under certain conditions may be recognized as occupational disease. The most frequent cause for irritant contact dermatitis is water (wet work). Natural optical radiation of different wavelength may cause light-induced inflammatory skin diseases. Phototoxic reactions due to psoralens, furocoumarins and drugs are frequent. The polymorphous light eruption is not an exogenous delayed type allergy, but seems to be a reaction against a UV-induced neoantigen of the skin. UVB exhibits direct mutagenic effects on DNA. Sun exposure and defective DNA-repair mechanisms are risk factors for skin tumors. Heat/cold exposure under specific conditions also triggers skin diseases (primary: congelations, frostbite, heat burn, scalding, chronic-inducible urticaria; secondary: deterioration of preexisting inflammatory diseases (e. g. systemic sclerosis)).
CONCLUSIONS
To keep the skin healthy, an early identification and elimination of harmful environmental factors and treatment of early disease stages is necessary. This requires strategies of environmental prevention and behavioral prevention, as well as global action (e. g. with regard to increasing incidence of skin cancer).
Topics: Dermatitis, Contact; Environmental Exposure; Environmental Pollutants; Evidence-Based Medicine; Filaggrin Proteins; Humans; Radiodermatitis; Sunlight; Ultraviolet Rays
PubMed: 28516256
DOI: 10.1007/s00103-017-2543-8