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Drug-induced photoallergic reaction
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Drug-induced photoallergic reaction

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Contributors: Susan Burgin MD, Michael D. Tharp MD, Neil Shear MD
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Synopsis

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.

Codes

ICD10CM:
L56.1 – Drug photoallergic response

SNOMEDCT:
80346008 – Photoallergic drug reaction

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

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.

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References

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Last Reviewed: 03/28/2018
Last Updated: 04/20/2018
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Drug-induced photoallergic reaction
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Drug-induced photoallergic reaction : Photosensitivity, Scaly papule, Scaly plaque, Tiny vesicle, Photodistributed
Clinical image of Drug-induced photoallergic reaction
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