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Photodermatology, Photoimmunology &... Aug 2012Photo-recall phenomenon is a phototoxic eruption occurring on areas of previous ultraviolet-induced solar erythema following a systemic administration of a drug. It has...
Photo-recall phenomenon is a phototoxic eruption occurring on areas of previous ultraviolet-induced solar erythema following a systemic administration of a drug. It has been mostly described with methotrexate but remains rare with other antineoplastic drugs. We describe a case of docetaxel-induced photo-recall skin rash in a woman treated for a non-small-cell lung cancer. Although the patient has refused to receive a second infusion, chemotherapy can be carried on with photoprotection and the use of topical and/or systemic corticosteroids. In contrast, radiation recall is a well-known reaction by oncologists, most of them may not be aware of a similar phenomenon called photo-recall phenomenon. Recognizing this entity may avoid misdiagnosing a drug allergy and should avoid inappropriate decisions of drug discontinuation.
Topics: Administration, Topical; Adrenal Cortex Hormones; Antineoplastic Agents; Carcinoma, Non-Small-Cell Lung; Dermatitis, Phototoxic; Docetaxel; Female; Humans; Lung Neoplasms; Middle Aged; Taxoids
PubMed: 23017178
DOI: 10.1111/j.1600-0781.2012.00669.x -
Journal of Pharmaceutical and... Jun 2001The photostability of diltiazem was studied in aqueous solutions at different pH values. Firstly, the hydrolysis of the drug to desacetyldiltiazem in alkaline medium was...
The photostability of diltiazem was studied in aqueous solutions at different pH values. Firstly, the hydrolysis of the drug to desacetyldiltiazem in alkaline medium was evaluated and then the drug photodegradation under exposure to UVA-UVB radiation (solar simulator) was monitored by HPLC methods. The main photoproduct was isolated and characterized as diltiazem-S-oxide on the basis of the NMR and mass spectra. The HPLC method was also applied to the selective analysis of diltiazem in commercial formulations. Tests on mutagenicity and photomutagenicity of the drug were also carried out using Salmonella typhimurium TA 102 strain. In this testing the drug neither was mutagenic nor toxic.
Topics: Calcium Channel Blockers; Chromatography, High Pressure Liquid; Dermatitis, Phototoxic; Diltiazem; Hydrolysis; Magnetic Resonance Spectroscopy; Mutagenicity Tests; Photolysis
PubMed: 11377039
DOI: 10.1016/s0731-7085(00)00588-4 -
Journal of Cutaneous Medicine and... 2004To better understand cutaneous photosensitivity reactions, a review of its etiologic factors, clinical characteristics, pathogenesis, and treatment modalities was... (Review)
Review
OBJECTIVE
To better understand cutaneous photosensitivity reactions, a review of its etiologic factors, clinical characteristics, pathogenesis, and treatment modalities was undertaken.
METHODS
Articles discussing the above aspects of phototoxic and photoallergic reactions were used to demonstrate what is currently known about photoinduced reactions and how to treat them.
RESULTS
Upon interaction of solar UV radiation with the chemical that is present in significant levels on the skin, one of two known reactions may occur in susceptible patients: a phototoxicity and/or photoallergy. Phototoxic and photoallergic reactions can be diagnosed separately on the basis of pathogenesis, clinical characteristics, and histology. Examples of drugs capable of inducing a phototoxic reaction include amiodarone, retinoids, nonsteroidal antiinflammatory agents, diuretics, and antibiotics. Substances known to cause a photoallergic response are fragrances, sunscreens, topical antimicrobials, NSAID, and psychiatric medications, such as chlorpromezine.
CONCLUSION
Photoinduced reactions produced by exogenous chemicals are common skin disorders. Definitive therapy requires identifying and removing the offending agent, either the photosensitizing chemical or light. The use of fully protective clothing and a sunscreen of high SPF are important measures when light exposure is inevitable.
Topics: Dermatitis, Photoallergic; Dermatitis, Phototoxic; Humans; Photosensitivity Disorders; Ultraviolet Rays
PubMed: 15988550
DOI: 10.1007/s10227-005-0017-3 -
Photodermatology, Photoimmunology &... Jun 2009Retinoids are photoreactive molecules found in skin and retinal tissue. The use of retinoids in pharmacologic doses, applied topically, raises the potential of... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Retinoids are photoreactive molecules found in skin and retinal tissue. The use of retinoids in pharmacologic doses, applied topically, raises the potential of phototoxicities. Recent review articles and current US drug labeling indicate that tretinoin is a phototoxin. In developing a new formulation of topical all-trans-retinoic acid (tretinoin), formal testing of dermal photoreactions was therefore undertaken.
METHODS
Four prospective, randomized, and controlled trials were carried out in healthy volunteers at two independent research facilities. Two trials examined phototoxicity following 24 h of drug exposure under occlusion (combined n=51), and two examined photoallergenicity following a 3-week, six dose induction phase (combined n=72) followed by challenge.
RESULTS
No phototoxic or photoallergic reactions occurred with tretinoin 0.05% in a new gel formulation.
CONCLUSION
The findings in these studies are consistent with previous studies of tretinoin in various formulations, and support the conclusion that tretinoin appears to be neither phototoxic nor photoallergenic in vivo.
Topics: Adult; Aged; Dermatitis, Phototoxic; Female; Humans; Male; Middle Aged; Prospective Studies; Tretinoin
PubMed: 19438994
DOI: 10.1111/j.1600-0781.2009.00433.x -
Clinics in Dermatology 1998
Review
Topics: Dermatitis, Phototoxic; Diagnosis, Differential; Humans; Porphyrias
PubMed: 9554238
DOI: 10.1016/s0738-081x(97)00205-8 -
Expert Opinion on Drug Safety Jul 2007Drug-induced photosensitivity involves reactions to medication triggered by exposure of the skin to ultraviolet light. Medications that trigger reactions can be topical... (Review)
Review
Drug-induced photosensitivity involves reactions to medication triggered by exposure of the skin to ultraviolet light. Medications that trigger reactions can be topical or oral. Following interaction of ultraviolet radiation with a chemical present in sufficient amounts in the skin, one of the several reactions may occur in susceptible patients, most commonly photoallergy or phototoxicity. These reactions can be diagnosed separately based on pathogenesis, clinical characteristics and histopathology. Phototoxic disorders have a higher incidence than photoallergic disorders. The action spectra for most photoallergens and phototoxins lie in the ultraviolet A range. Subtypes of drug-induced photosensitivity include dyschromia, pseudoporphyria, photo onycholysis, and lichenoid and telangiectatic reactions.
Topics: Allergens; Animals; Dermatitis, Photoallergic; Dermatitis, Phototoxic; Humans; Photosensitivity Disorders; Ultraviolet Rays
PubMed: 17688387
DOI: 10.1517/14740338.6.4.431 -
Photodermatology, Photoimmunology &... Oct 2002
Review
Topics: Dermatitis, Photoallergic; Dermatitis, Phototoxic; Humans; Photosensitivity Disorders
PubMed: 12390668
DOI: 10.1034/j.1600-0781.2002.02778.x -
The British Journal of Dermatology Nov 2009Photodermatoses are skin disorders induced or exacerbated by light. They can be broadly classified into four groups: (i) immunologically mediated photodermatoses... (Review)
Review
Photodermatoses are skin disorders induced or exacerbated by light. They can be broadly classified into four groups: (i) immunologically mediated photodermatoses (idioapathic); (ii) drug- and chemical-induced photosensitivity; (iii) defective DNA repair disorders; and (iv) photoaggravated dermatoses. The exact pathomechanism of those diverse skin reactions to light radiation remains unclear. Immunologically mediated photodermatoses are the most common dermatoses among all photosesnsitive disorders. The management of photodermatoses starts with clinical recognition of characteristic lesions localized predominantly in light exposed skin. Detailed history-taking, phototesting and photopatch testing are required to establish a correct diagnosis, especially if patients present in disease-free intervals. Classification and short description of distinctive clinical features of most common photodermatoses, several practical aspects of evaluation and management of the patient with photosensitivity will be outlined.
Topics: Dermatitis, Photoallergic; Dermatitis, Phototoxic; Female; Humans; Male; Patch Tests; Physical Examination; Skin Diseases, Papulosquamous; Ultraviolet Rays
PubMed: 19775359
DOI: 10.1111/j.1365-2133.2009.09451.x -
Archives of Environmental Contamination... Apr 1997The photoinduced toxicity of several environmental pollutants (some Polycyclic Aromatic Hydrocarbons [PAHs]) is a potential threat to aquatic organisms. To identify the...
The photoinduced toxicity of several environmental pollutants (some Polycyclic Aromatic Hydrocarbons [PAHs]) is a potential threat to aquatic organisms. To identify the cause/s of photoinduced toxicity of a sample, it is not sufficient to simply analyze the content of some known phototoxic compounds; so far too few substances of environmental concern have ever been tested for their photoinduced toxicity. The PAHs as well as other known phototoxic compounds are hydrophobic and are expected to bind to C18 columns. The use of Solid Phase Extraction (SPE) is typically part of the procedure identifying any primary nonpolar toxicant/s, and adding phototoxicity tests to these manipulations would not substantially increase the workload. In this study, therefore, the difference in acute toxicity to Daphnia magna before and after 2 h of UV irradiation was determined for six PAHs. The ratio between EC50 values before and after UV irradiation ranged from 4.6 (for benzo-a-pyrene) to >244 (for 3, 4-benzofluoranthene), demonstrating that the UV enhances the PAH-toxicity. A further characterization technique using binding to Sep-Pak SPE C18 columns and recovery with methanol as an eluting agent was then tested in combination with UV irradiation. The mean recovered UV induced toxicity after binding and elution of the six PAHs was 119% according to the phototoxicity tests made. A linear relationship, between the log10 Kow values for the PAHs and the log10 for the concentration of methanol at peak elution was found. The combined use of C18 column separation and UV activation may, therefore, be used in toxicity identification evaluations (TIE) of organic phototoxic compounds.
Topics: Animals; Daphnia; Dermatitis, Phototoxic; Ultraviolet Rays; Water Pollutants, Chemical
PubMed: 9096075
DOI: 10.1007/s002449900184 -
Clinics in Dermatology 2015Patients with photosensitive disorders of the skin may present with ocular manifestations that are evident at birth or may be manifested later with progression of the... (Review)
Review
Patients with photosensitive disorders of the skin may present with ocular manifestations that are evident at birth or may be manifested later with progression of the disorder. Dermatologists should be able to recognize these and appropriately refer patients for further management. Ocular involvement associated with immunologically mediated photodermatoses, drug- and chemical-induced photosensitivity, photodermatoses associated with defective DNA repair/chromosome instability, and photoaggravated dermatoses are reviewed. Photodermatoses are commonly classified into four general groups: (1) immunologically mediated photodermatoses; (2) drug- and chemical-induced photosensitivity; (3) photodermatoses associated with defective DNA repair/chromosome instability; and (4) photoaggravated dermatoses. Photodermatoses in these groups with ocular involvement will be discussed. In addition, skin diseases associated with photophobia are also described.
Topics: Comorbidity; Dermatitis, Photoallergic; Dermatitis, Phototoxic; Eye Diseases; Female; Humans; Incidence; Male; Photosensitivity Disorders; Prognosis; Risk Assessment; Severity of Illness Index
PubMed: 25704944
DOI: 10.1016/j.clindermatol.2014.10.016