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Frontiers in Allergy 2022Drug-induced photosensitivity (DIP) is a common cutaneous adverse drug reaction, resulting from the interaction of ultraviolet radiations, mostly ultraviolet A, with... (Review)
Review
Drug-induced photosensitivity (DIP) is a common cutaneous adverse drug reaction, resulting from the interaction of ultraviolet radiations, mostly ultraviolet A, with drugs. DIP includes phototoxicity and photoallergy. A phototoxic reaction is obtained when topical and systemic drugs or their metabolites absorb light inducing a direct cellular damage, while a photoallergic reaction takes place when the interaction between drugs and ultraviolet radiations causes an immune cutaneous response. Clinically, phototoxicity is immediate and appears as an exaggerated sunburn, whereas photoallergy is a delayed eczematous reaction. DIP may show several clinical subtypes. In this mini-review we report the pathogenetic mechanisms and causative drugs of DIP. We offer a detailed description of DIP clinical features in its classical and unusual subtypes, such as hyperpigmentation/dyschromia, pseudoporphyria, photo-onycolysis, eruptive teleangiectasia, pellagra-like reaction, lichenoid reaction, photodistributed erythema multiforme and subacute/chronic cutaneous lupus erythematosus. We described how physicians may early recognize and manage DIP, including diagnostic tests to rule out similar conditions. We made suggestions on how to improve sun exposure behaviors of patients at risk of DIP by means of an aware use of sunscreens, protective clothing and recent technologic tools. We highlighted the lack of sun safety programs addressed to patients at risk of DIP, who need a formal education about their condition.
PubMed: 36238932
DOI: 10.3389/falgy.2022.876695 -
Dermatology Online Journal Jul 2021
Topics: Aged; Dermatitis, Phototoxic; Hand Dermatoses; Humans; Male; Ruta
PubMed: 34391344
DOI: 10.5070/D327754382 -
ACS Nano Jun 2023Intratumoral pathogens can contribute to cancer progression and affect therapeutic response. , a core pathogen of colorectal cancer (CRC), is an important cause of low...
Intratumoral pathogens can contribute to cancer progression and affect therapeutic response. , a core pathogen of colorectal cancer (CRC), is an important cause of low therapeutic efficacy and metastasis. Thus, the modulation of intratumoral pathogens may provide a target for cancer therapy and metastasis inhibition. Herein, we propose an intratumoral -modulating strategy for enhancing the therapeutic efficacy of CRC and inhibiting lung metastasis by designing an antibacterial nanoplatform (Au@BSA-CuPpIX), which produced reactive oxygen species (ROS) under ultrasound and exhibited strong antibacterial activity. Importantly, Au@BSA-CuPpIX reduced the levels of apoptosis-inhibiting proteins by inhibiting intratumoral , thereby enhancing ROS-induced apoptosis. results demonstrated that Au@BSA-CuPpIX effectively eliminated to enhance the therapeutic efficacy of sonodynamic therapy (SDT) for orthotopic CRC and inhibit lung metastasis. Notably, entrapped gold nanoparticles reduced the phototoxicity of metalloporphyrin accumulated in the skin during tumor treatment, preventing severe inflammation and damage to the skin. Therefore, this study proposes a strategy for the elimination of in CRC to enhance the therapeutic effect of SDT, thus providing a promising paradigm for improving cancer treatment with fewer toxic side effects and promoting the clinical translational potential of SDT.
Topics: Humans; Fusobacterium nucleatum; Colorectal Neoplasms; Gold; Reactive Oxygen Species; Metal Nanoparticles
PubMed: 37201179
DOI: 10.1021/acsnano.3c01308 -
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 -
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 -
Alternatives To Laboratory Animals :... Jun 2024Phototoxicity testing is crucial for evaluating the potential harmful effects of pharmaceuticals and chemicals on human skin when exposed to sunlight. Traditional...
Phototoxicity testing is crucial for evaluating the potential harmful effects of pharmaceuticals and chemicals on human skin when exposed to sunlight. Traditional models involving mice, rats, guinea pigs, as well as assays such as the 3T3 Neutral Red Uptake phototoxicity assay and methods based on the use of reconstructed human epidermis, have been established for phototoxicity testing. While these approaches are extremely valuable, they are costly in terms of both time and resources. Consequently, approaches based on the use of predictive software tools can offer more rapid and cost-effective phototoxicity screening solutions. With this goal in mind, the current study evaluated two tools - Derek Nexus 6.1.0/Derek Knowledge Base 2020 1.0 (Lhasa Limited, UK) and the QSAR Toolbox (v 4.5) developed by the Organisation for Economic Co-operation and Development (OECD) - for their capacity to predict the phototoxicity of several substances from diverse classes. Derek Nexus and the QSAR Toolbox were both found to be very useful for predicting the phototoxicity of drugs and other chemicals. Derek Nexus predicted phototoxicity of the compounds, with a sensitivity of 63%, specificity of 93%, Positive Predictive Values of 90% and Negative Predictive Value of 69%, overall accuracy of 77% and balanced accuracy of 78%. The QSAR Toolbox achieved sensitivity of 73%, specificity of 85%, Positive Predictive Value of 85% and Negative Predictive Value of 74%, overall accuracy of 79% and balanced accuracy of 79%. The results show that Derek Nexus and the QSAR Toolbox can be usefully incorporated in the workflow of phototoxicity testing for pharmaceuticals and chemicals.
PubMed: 38910363
DOI: 10.1177/02611929241256040 -
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 -
Wideochirurgia I Inne Techniki... Jun 2022Erythropoietic protoporphyria is a hereditary defect in heme synthesis, causing protoporphyrin deposition and phototoxic reactions after exposure to light, especially at...
Erythropoietic protoporphyria is a hereditary defect in heme synthesis, causing protoporphyrin deposition and phototoxic reactions after exposure to light, especially at a wavelength of about 400 nm. Sensitivity to light may cause postoperative complications. Therefore, in open surgery protective filters are employed on surgical luminaires. The dangers of laparoscopy are little understood and the intensity of the light used can be high. To protect against phototoxic injury, we inserted an OG 530 filter in the video track. This filter blocks wavelengths below 470 nm. Three cholecystectomies and one sigmoidectomies were performed laparoscopically. The procedures were uneventful, and the patients suffered no adverse reactions, including phototoxic symptoms. The filter had a moderate influence on color perception and caused no significant restrictions on working conditions. We consider that it is appropriate to develop a relevant design to meet the suitable requirements for a durable filter holder in the laparoscopic video track.
PubMed: 35707342
DOI: 10.5114/wiitm.2022.115003 -
JAAPA : Official Journal of the... Jun 2023Many medications are associated with phototoxicity or photoallergy, the two types of photosensitivity. Recently, a warning related to increased skin cancer risk was... (Review)
Review
Many medications are associated with phototoxicity or photoallergy, the two types of photosensitivity. Recently, a warning related to increased skin cancer risk was added to the labeling of the popular diuretic hydrochlorothiazide. This article reviews some photosensitizing medications and describes patient education on preventing and recognizing photosensitivity reactions and skin cancer.
Topics: Humans; Dermatitis, Phototoxic; Photosensitivity Disorders; Dermatitis, Photoallergic; Hydrochlorothiazide; Skin Neoplasms
PubMed: 37229580
DOI: 10.1097/01.JAA.0000931448.63999.de