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Dermatitis : Contact, Atopic,... 2024
Topics: Humans; Hydrochlorothiazide; Vitiligo; Dermatitis, Phototoxic; Ultraviolet Rays
PubMed: 38150560
DOI: 10.1089/derm.2023.0161 -
Journal of the American Academy of... Feb 2015Voriconazole, an antifungal agent, is associated with various cutaneous reactions, including phototoxicity, accelerated photoaging, and skin cancer. Incidence and risk...
BACKGROUND
Voriconazole, an antifungal agent, is associated with various cutaneous reactions, including phototoxicity, accelerated photoaging, and skin cancer. Incidence and risk factors for these reactions in children have not been well described.
OBJECTIVE
We sought to determine the incidence of and factors associated with phototoxic reactions and nonmelanoma skin cancer in pediatric patients treated with voriconazole.
METHODS
This was a retrospective analysis of 430 pediatric patients treated with voriconazole between 2003 and 2013 at Boston Children's Hospital.
RESULTS
Incidence of phototoxicity was 20% in all children treated with voriconazole and 47% in children treated for 6 months or longer. Factors associated with phototoxicity included white race, cystic fibrosis, cumulative treatment time, and cumulative dose. Four patients (1%) had nonmelanoma skin cancer; all experienced a phototoxic reaction during voriconazole treatment. Of those with phototoxicity, 5% were discontinued on voriconazole, 6% were referred to dermatology, and 26% received counseling about sun protection from their primary physician.
LIMITATIONS
Our study is limited by its retrospective design and potential referral bias associated with a tertiary-care center.
CONCLUSIONS
Voriconazole-associated phototoxicity is relatively common in children and may lead to nonmelanoma skin cancer. However, those with phototoxic reactions are often continued on therapy, rarely referred to dermatology, and infrequently counseled on sun protection.
Topics: Adolescent; Antifungal Agents; Boston; Carcinoma, Squamous Cell; Causality; Child; Comorbidity; Cystic Fibrosis; Dermatitis, Phototoxic; Female; Humans; Immunocompromised Host; Incidence; Male; Mycoses; Retrospective Studies; Risk Factors; Skin Neoplasms; Voriconazole; White People
PubMed: 25481710
DOI: 10.1016/j.jaad.2014.10.023 -
Journal of Pediatric and Adolescent... Apr 2014Phytophotodermatitis is a phototoxic cutaneous eruption due to skin exposure to furocourmarins combined with ultraviolet light. Bizzare linear patterns, ranging from...
Phytophotodermatitis is a phototoxic cutaneous eruption due to skin exposure to furocourmarins combined with ultraviolet light. Bizzare linear patterns, ranging from erythema to bullae with residual hyperpigmentaion, is the clinical clue to this diagnosis. Avoidance of furocoumarins in direct sunlight can prevent recurrences.
Topics: Adolescent; Citrus; Dermatitis, Phototoxic; Female; Furocoumarins; Humans; Sunlight
PubMed: 24745072
DOI: 10.1016/j.jpag.2013.11.001 -
Alternatives To Laboratory Animals :... Nov 2004Relationships between the structure and properties of chemicals can be programmed into knowledge-based systems such as DEREK for Windows (DEREK is an acronym for... (Review)
Review
Relationships between the structure and properties of chemicals can be programmed into knowledge-based systems such as DEREK for Windows (DEREK is an acronym for "Deductive Estimation of Risk from Existing Knowledge"). The DEREK for Windows computer system contains a subset of over 60 rules describing chemical substructures (toxophores) responsible for skin sensitisation. As part of the European Phototox Project, the rule base was supplemented by a number of rules for the prospective identification of photoallergens, either by extension of the scope of existing rules or by the generation of new rules where a sound mechanistic rationale for the biological activity could be established. The scope of the rules for photoallergenicity was then further refined by assessment against a list of chemicals identified as photosensitisers by the Centro de Farmacovigilancia de la Comunidad Valenciana, Valencia, Spain. This paper contains an analysis of the mechanistic bases of activity for eight important groups of photoallergens and phototoxins, together with rules for the prospective identification of the photobiological activity of new or untested chemicals belonging to those classes. The mechanism of action of one additional chemical, nitrofurantoin, is well established; however, it was deemed inappropriate to write a rule on the basis of a single chemical structure.
Topics: Allergens; Chemical Phenomena; Chemistry, Physical; Dermatitis, Contact; Dermatitis, Photoallergic; Dermatitis, Phototoxic; Molecular Structure; Software; Spain; Structure-Activity Relationship; Toxicity Tests
PubMed: 15656774
DOI: 10.1177/026119290403200506 -
Expert Opinion on Investigational Drugs Dec 2010Afamelanotide, an α-melanocyte stimulating hormone (MSH) agonistic analog is a first-in-class therapeutic. Its application to protoporphyria (PP), a disease associated... (Review)
Review
IMPORTANCE OF THE FIELD
Afamelanotide, an α-melanocyte stimulating hormone (MSH) agonistic analog is a first-in-class therapeutic. Its application to protoporphyria (PP), a disease associated with absolute sunlight-intolerance is discussed.
AREAS COVERED IN THIS REVIEW
The genetics and existing therapy of the inherited disease PP comprising both erythropoietic protoporphyria and X-linked dominant protoporphyria. The physiological and pharmacological actions of α-MSH and afamelanotide including receptor-mediated intracellular signaling and effects of receptor polymorphisms. Adverse effects and safety issues.
WHAT THE READER WILL GAIN
The clinical severity and the necessity for an effective therapy for the rare disease PP are illustrated by a short, up-to-date portrait. A condensed description of clinically important aspects of α-MSH signaling, physiological, pharmacological and safety issues of afamelanotide applied to humans and the rational for its potential efficacy in PP are given. The different trials of afamelanotide in PP and their most recent results are discussed.
TAKE HOME MESSAGE
Although early, results of the first trials of afamelanotide for PP are promising and the risk-safety profile appears favorable today. We expect afamelanotide and analogs thereof to be a prospective therapeutic tool in light-related skin diseases, and in future this drug class might prove effectiveness in other medical conditions.
Topics: Administration, Cutaneous; Animals; Clinical Trials as Topic; Dermatitis, Phototoxic; Humans; Protoporphyria, Erythropoietic; Skin; alpha-MSH
PubMed: 21073357
DOI: 10.1517/13543784.2010.535515 -
Yakugaku Zasshi : Journal of the... Mar 2005The present study examined the phototoxicities of a series of 7-(3-aminopyrrolidinyl) quinolones containing various substituents at position 1 by use of a mouse model.... (Review)
Review
The present study examined the phototoxicities of a series of 7-(3-aminopyrrolidinyl) quinolones containing various substituents at position 1 by use of a mouse model. For the 7-(3-aminopyrrolidinyl) quinolones with a halogen atom at position 8, well-known substituent groups such as a cyclopropyl, an ethyl, or a difluorophenyl at position 1 were found to be responsible for severe phototoxicity. However, when an aminodifluorophenyl or an isoxazolyl group was placed at position 1, even 8-halogeno quinolones were found to be mildly phototoxic. This is the first report of 8-halogeno quinolones that are not severely phototoxic. Two structurally similar 8-chloro quinolones (the 1-aminodifluorophenyl 8-chloro quinolone and the 1-difluorophenyl 8-chloro quinolone) were investigated further. The former was mildly phototoxic; the latter was severely phototoxic. We demonstrate that these two 8-chloro quinolones have practically the same areas under the concentration-time curves from 0 to 4 h in auricular tissue, suggesting that the mild phototoxicity is not due to pharmacokinetic instability. The rates of UV photodegradation of these compounds were also measured. We found that these two quinolones photodegrade at similar rates, suggesting that the mild phototoxicity is not attained through increased photostability. In conclusion, the phototoxic potentials of fluoroquinolones are influenced not only by the substituent at position 8 but also by that at position 1. We also discovered a mildly phototoxic 8-chloro quinolone which did not have increased photostability.
Topics: Animals; Dermatitis, Phototoxic; Drug Design; Drug Stability; Fluoroquinolones; Mice; Structure-Activity Relationship; Ultraviolet Rays
PubMed: 15738624
DOI: 10.1248/yakushi.125.255 -
International Journal of Dermatology Dec 2023
Topics: Humans; Dermatitis, Phototoxic; Dronedarone; Anti-Arrhythmia Agents
PubMed: 37700581
DOI: 10.1111/ijd.16845 -
Photodermatology, Photoimmunology &... Feb 2010
Review
Topics: Animals; Dermatitis, Phototoxic; Humans; Ultraviolet Rays; Ultraviolet Therapy
PubMed: 20070831
DOI: 10.1111/j.1600-0781.2009.00487.x -
Toxicologic Pathology Jun 2016Determination of test material-induced cutaneous phototoxicity for risk assessment has traditionally been based on visually observed skin reactions such as erythema,...
Determination of test material-induced cutaneous phototoxicity for risk assessment has traditionally been based on visually observed skin reactions such as erythema, edema, and flaking. Because of its role in determining a toxic effect, the use of histopathological evaluation in this determination arises from time to time. However, there is little published information regarding the time course and types of histopathologic changes in the skin after test material-induced phototoxic insult nor any regulatory requirement or precedent for its use. This work evaluated both the visual and histopathological time course of the phototoxic response of the skin of the Long-Evans rat after oral administration of the phototoxins sparfloxacin and 8-methoxypsoralen (MOP) followed by a single exposure to solar-simulated ultraviolet radiation. Both sparfloxacin and 8-MOP elicited visual cutaneous reactions and microscopic changes consistent with a phototoxic response. The visually observed cutaneous time course and elicited histopathologic changes differed in response and extent for each phototoxin, but in both instances, microscopic evaluation did not alter the determination of a phototoxic response based on visual observations. These results indicate that, though histopathologic evaluations may have value for investigating mechanisms of phototoxicity, histopathologic evaluation of the skin is not warranted for determination of phototoxic potential in safety assessment intended for regulatory submission.
Topics: Animals; Dermatitis, Phototoxic; Female; Rats; Rats, Long-Evans
PubMed: 27073086
DOI: 10.1177/0192623316643617 -
International Journal of Dermatology May 2021
Topics: Anti-Inflammatory Agents, Non-Steroidal; Dermatitis, Phototoxic; Humans; Pyridones
PubMed: 33615459
DOI: 10.1111/ijd.15361