Drug-induced photoallergic reaction
Alerts and Notices
Synopsis
Drug-induced photoallergic reactions are allergic reactions due to ultraviolet light (UVL)-induced alteration of a drug. They are dose independent and do not occur in all patients. Patients typically complain of itching rather than burning, and symptoms tend to be chronic. Common offenders include the following: sunscreens (benzophenones, cinnamates), fragrances (musk ambrette, sandalwood oil), topical antimicrobial agents (chlorhexidine, fenticlor, hexachlorophene), NSAIDs (diclofenac, ketoprofen, piroxicam, celecoxib), phenothiazines (chlorpromazine, promethazine), antiarrhythmics (quinidine), antifungals (griseofulvin), antimalarials (quinine), quinolones (enoxacin, lomefloxacin), sulphonylureas (glipizide), and sulfonamides. Trimethoprim and sulfamethoxazole are common causes in immunosuppressed patients.
Drug-induced photoallergic reactions manifest as red, scaling, pruritic (eczematous) papules and plaques in photodistributed areas (forehead, malar areas, sides of neck, and dorsum of the hands). This eruption is often pruritic and looks like chronic atopic dermatitis with a photodistribution.
Codes
ICD10CM:L56.1 – Drug photoallergic response
SNOMEDCT:
69047008 – Drug-induced photosensitivity
Look For
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Sunburn
- Photosensitive reaction
- Chronic actinic dermatitis
- Systemic lupus erythematosus
- Dermatomyositis
- Porphyria cutanea tarda
- Pseudoporphyria
- Airborne allergic contact dermatitis
- Phytophotodermatitis
- Widespread contact dermatitis (see irritant, allergic)
- Lichen planus (if lichenoid papules are present)
- Atopic dermatitis
- Subacute cutaneous lupus
- Pemphigus foliaceus
- Pellagra
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:03/27/2018
Last Updated:04/19/2018
Last Updated:04/19/2018
Drug-induced photoallergic reaction