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Journal of the European Academy of... Jun 2022Drug-induced photosensitivity is associated with a wide range of anticancer treatments, including conventional chemotherapeutic agents, targeted anticancer therapies,... (Review)
Review
Drug-induced photosensitivity is associated with a wide range of anticancer treatments, including conventional chemotherapeutic agents, targeted anticancer therapies, and immune checkpoint inhibitors. These dermatologic adverse events can have a major impact on the well-being and quality of life of cancer patients, leading to dose modifications and interruption or discontinuation of anticancer treatments in severe cases. However, the heterogeneous nature of the photosensitive reactions induced by these agents, as well as the common concomitant use of other potentially photosensitizing drugs (antibiotics, voriconazole, nonsteroidal anti-inflammatory drugs, etc.), can make the diagnosis and, therefore the prevention, of these adverse events particularly challenging. The aim of this review is to describe the most characteristic forms of photosensitivity observed in patients being treated with anticancer treatments, including phototoxicity and photoallergy, and other potentially photo-induced manifestations such as UV recall, exaggerated sunburn reactions associated with treatment-related vitiligo, drug-induced cutaneous lupus erythematosus, and UV-induced hyperpigmentation. We also discuss the photosensitive reactions recently reported with new-generation targeted anticancer therapies and immune checkpoint inhibitors and highlight the importance of continued surveillance to identify photosensitizing agents, and of educating patients on the need for preventive UVA/UVB photoprotective measures.
Topics: Dermatitis, Photoallergic; Dermatitis, Phototoxic; Humans; Immune Checkpoint Inhibitors; Photosensitivity Disorders; Quality of Life
PubMed: 35738806
DOI: 10.1111/jdv.18200 -
Dermatitis : Contact, Atopic,...Phytophotodermatitis is a cutaneous reaction that occurs after exposure to plant-derived furocoumarins and ultraviolet A light. Psoralen is the most common phototoxic... (Review)
Review
Phytophotodermatitis is a cutaneous reaction that occurs after exposure to plant-derived furocoumarins and ultraviolet A light. Psoralen is the most common phototoxic furocoumarin and is present in varying levels within many different plant species. This article focuses on the diagnosis and management of psoralen-induced phytophotodermatitis along with other clinical applications.
Topics: Dermatitis, Phototoxic; Ficusin; Furocoumarins; Humans; Photosensitivity Disorders; Plants, Toxic; Ultraviolet Rays
PubMed: 33273237
DOI: 10.1097/DER.0000000000000691 -
The New England Journal of Medicine Apr 2023Erythropoietic protoporphyria and X-linked protoporphyria are inborn errors of heme biosynthesis that cause elevated circulating levels of metal-free protoporphyrin and... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Erythropoietic protoporphyria and X-linked protoporphyria are inborn errors of heme biosynthesis that cause elevated circulating levels of metal-free protoporphyrin and phototoxicity. Both disorders are characterized by excruciating phototoxic attacks after exposure to visible light. Dersimelagon is a new, orally administered, selective melanocortin 1 receptor agonist that increases levels of skin eumelanin.
METHODS
We conducted a randomized, placebo-controlled, phase 2 trial to investigate the efficacy and safety of dersimelagon with respect to the time to onset and the severity of symptoms associated with sunlight exposure in patients with erythropoietic protoporphyria or X-linked protoporphyria. Patients 18 to 75 years of age were randomly assigned in a 1:1:1 ratio to receive placebo or dersimelagon at a dose of 100 or 300 mg once daily for 16 weeks. The primary end point was the change from baseline to week 16 in the time to the first prodromal symptom associated with sunlight exposure. Patients recorded daily sunlight exposure and symptom data in an electronic diary. Quality of life and safety were also assessed.
RESULTS
Of the 102 patients (93 with erythropoietic protoporphyria and 9 with X-linked protoporphyria) who underwent randomization, 90% completed the treatment period. The mean daily time to the first prodromal symptom associated with sunlight exposure increased significantly with dersimelagon: the least-squares mean difference from placebo in the change from baseline to week 16 was 53.8 minutes in the 100-mg dersimelagon group (P = 0.008) and 62.5 minutes in the 300-mg dersimelagon group (P = 0.003). The results also suggest that quality of life improved in patients receiving dersimelagon as compared with placebo. The most common adverse events that occurred or worsened during treatment were nausea, freckles, headache, and skin hyperpigmentation.
CONCLUSIONS
At both doses evaluated, dersimelagon significantly increased the duration of symptom-free sunlight exposure in patients with erythropoietic protoporphyria or X-linked protoporphyria. (Funded by Mitsubishi Tanabe Pharma; Endeavor ClinicalTrials.gov number, NCT03520036.).
Topics: Humans; Infant, Newborn; Prodromal Symptoms; Protoporphyria, Erythropoietic; Quality of Life; Skin; Light; Photosensitivity Disorders; Receptor, Melanocortin, Type 1; Administration, Oral; Dermatologic Agents
PubMed: 37043653
DOI: 10.1056/NEJMoa2208754 -
Dermatologic Clinics Jan 2020An interaction between light's radiation and certain exogenous and endogenous substances can lead to the development of photoallergic and/or phototoxic dermatoses.... (Review)
Review
An interaction between light's radiation and certain exogenous and endogenous substances can lead to the development of photoallergic and/or phototoxic dermatoses. Clinically, reactions may range from acute and self-limited to chronic and recurrent. Delays in diagnosis are not uncommon due to complex clinical presentations, broad differentials, and limited number of specialists who perform phototesting. Therefore, a critical understanding of these dermatoses is essential for accurate diagnosis and appropriate management. The epidemiology, light sources, mechanisms, clinical presentations, evaluation protocols, common culprits, treatments, key challenges, and future directions related to photoallergy and phototoxicity are reviewed herein.
Topics: Dermatitis, Photoallergic; Dermatitis, Phototoxic; Disease Management; Humans; Skin Tests
PubMed: 31753189
DOI: 10.1016/j.det.2019.08.010 -
Chemistry & Biodiversity Aug 2020Curcumin is a plant-derived polyphenolic active substance with broad-spectrum antibacterial properties. Curcumin blocks bacterial growth owing to its structural... (Review)
Review
Curcumin is a plant-derived polyphenolic active substance with broad-spectrum antibacterial properties. Curcumin blocks bacterial growth owing to its structural characteristics and the generation of antioxidation products. Curcumin can inhibit bacterial virulence factors, inhibit bacterial biofilm formation and prevent bacterial adhesion to host receptors through the bacterial quorum sensing regulation system. As a photosensitizer, curcumin acts under blue light irradiation to induce phototoxicity and inhibit bacterial growth. Moreover, it can exert a synergistic antibacterial effect with other antibacterial substances. In this review, we summarize the research progress on the antibacterial mechanism of curcumin based on five targeting structures and two modes of action. Our discussion provides a theoretical basis and technical foundation for the development and application of natural antibacterial agents.
Topics: Anti-Bacterial Agents; Bacteria; Cell Wall; Curcumin; Light; Microbial Sensitivity Tests; Photosensitizing Agents
PubMed: 32533635
DOI: 10.1002/cbdv.202000171 -
The Journal of Pediatrics Jan 2024
Topics: Humans; Pastinaca; Dermatitis, Phototoxic
PubMed: 37696389
DOI: 10.1016/j.jpeds.2023.113727 -
Frontiers in Allergy 2023Photosensitive dermatoses are seen in 5% of HIV-infected persons. These include drug- and chemical-induced photoallergic and phototoxic reactions, chronic actinic... (Review)
Review
Photosensitive dermatoses are seen in 5% of HIV-infected persons. These include drug- and chemical-induced photoallergic and phototoxic reactions, chronic actinic dermatitis of HIV, photo lichenoid drug eruptions, and porphyria. Data on photodermatitis in HIV are limited to case reports and series. The pathogenesis is not completely understood and includes a th2 phenotype in HIV which results in impaired barrier function and resultant allergen sensitisation as well as immune dysregulation. The objective of this manuscript is to review the literature on the clinical phenotype, pathogenesis, role of photo and patch testing, outcomes, and treatment of photodermatitis in HIV in an African population.
PubMed: 37216149
DOI: 10.3389/falgy.2023.1159387 -
Experimental Dermatology Jun 2023Ultraviolet B exposure to keratinocytes promotes carcinogenesis by inducing pyrimidine dimer lesions in DNA, suppressing the nucleotide excision repair mechanism... (Review)
Review
Ultraviolet B exposure to keratinocytes promotes carcinogenesis by inducing pyrimidine dimer lesions in DNA, suppressing the nucleotide excision repair mechanism required to fix them, inhibiting the apoptosis required for the elimination of initiated cells, and driving cellular proliferation. Certain nutraceuticals - most prominently spirulina, soy isoflavones, long-chain omega-3 fatty acids, the green tea catechin epigallocatechin gallate (EGCG) and Polypodium leucotomos extract - have been shown to oppose photocarcinogenesis, as well as sunburn and photoaging, in UVB-exposed hairless mice. It is proposed that spirulina provides protection in this regard via phycocyanobilin-mediated inhibition of Nox1-dependent NADPH oxidase; that soy isoflavones do so by opposing NF-κB transcriptional activity via oestrogen receptor-beta; that the benefit of eicosapentaenoic acid reflects decreased production of prostaglandin E2; and that EGCG counters UVB-mediated phototoxicity via inhibition of the epidermal growth factor receptor. The prospects for practical nutraceutical down-regulation of photocarcinogenesis, sunburn, and photoaging appear favourable.
Topics: Animals; Mice; Sunburn; Ultraviolet Rays; Keratinocytes; Dietary Supplements; Isoflavones; Mice, Hairless
PubMed: 36811352
DOI: 10.1111/exd.14777 -
Oxford Medical Case Reports Nov 2019Phytophotodermatitis, also commonly known as phototoxic dermatitis, is a common skin condition that occurs after contact with certain plants and subsequent exposure to...
Phytophotodermatitis, also commonly known as phototoxic dermatitis, is a common skin condition that occurs after contact with certain plants and subsequent exposure to sunlight. It is often confused with skin burns due to the blistering nature of its lesions. We herein report a case of phytophotodermatitis that developed in a 26-year-old male following contact with lime and subsequent exposure to sunlight.
PubMed: 31844529
DOI: 10.1093/omcr/omz113