SynopsisCodesLook ForDiagnostic PearlsDifferential Diagnosis & PitfallsBest TestsManagement PearlsTherapyDrug Reaction DataReferences

View all Images (20)

Drug-induced photoallergic reaction
Other Resources UpToDate PubMed

Drug-induced photoallergic reaction

Contributors: Susan Burgin MD, Michael D. Tharp MD, Neil Shear MD
Other Resources UpToDate PubMed


Drug-induced photosensitivity can be divided into 2 kinds of reactions: phototoxic and photoallergic.

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.


L56.1 – Drug photoallergic response

69047008 – Drug-induced photosensitivity

Look For

Subscription Required

Diagnostic Pearls

Subscription Required

Differential Diagnosis & Pitfalls

  • Sunburn
  • Drug-induced photosensitive reaction
  • Chronic actinic dermatitis
  • Systemic lupus erythematosus
  • Dermatomyositis
  • Porphyria cutanea tarda
  • Pseudoporphyria
  • Airborne Allergic contact dermatitis
  • Phytophotodermatitis
  • Widespread contact dermatitis (see Irritant contact dermatitis, Allergic contact dermatitis)
  • Lichen planus (if lichenoid papules are present)
  • Atopic dermatitis
  • Subacute cutaneous lupus erythematosus
  • Pemphigus foliaceus
  • Pellagra

Best Tests

Subscription Required

Management Pearls

Subscription Required


Subscription Required

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


Subscription Required

Last Reviewed:03/27/2018
Last Updated:04/19/2018
Copyright © 2024 VisualDx®. All rights reserved.
Drug-induced photoallergic reaction
A medical illustration showing key findings of Drug-induced photoallergic reaction : Photosensitivity, Scaly papule, Scaly plaque, Tiny vesicle, Photodistributed
Clinical image of Drug-induced photoallergic reaction - imageId=341044. Click to open in gallery.  caption: 'Widespread scaly and crusted pink plaques on dorsal hands and fingers, secondary to a medication.'
Widespread scaly and crusted pink plaques on dorsal hands and fingers, secondary to a medication.
Copyright © 2024 VisualDx®. All rights reserved.