Abstract
Fototoksik dermatit fotosensitif ajanın sistemik alımından sonra güneş gören yerlerde gelişen reaksiyondur. Oral alınan ilaçlarla oluşan fototoksik reaksiyonlar güneş yanığına benzer. Reaksiyon ilacın kesilmesinden sonra hiperpigmentasyon bırakarak geriler. Fotoonikoliz ve psödoporfirya ilaca bağlı fototoksisitenin nadir görülen sonuçlarıdır. Fototoksik reaksiyon ve fotoonikolizden en çok sorumlu olan ilaçlar tetrasiklin grubu (özellikle doksisiklin, demeklosiklin), nonsteroid antiinflamatuvar ilaçlar (propionik asit türevleri) ve florokinolonlardır. Doksisiklin tetrasiklin grubundan bir antibiyotik olup akne vulgaris hastalarında sıklıkla tercih edilir. Bu yazıda, brusella nedeniyle rifampisin ve doksisiklin kullanan ve fototoksik dermatit gelişen 12 yaşında bayan hasta sunulmuştur. Olgunun tüm el tırnak distallerinde kahverengi renk değişikliği mevcuttu. Dermatolojik muayenede yüz orta hatta özellikle burun üzerinde ve yanaklarda soluk eritemli sınırları düzensiz ve belirsiz bazı yerlerde yapışık kurutların olduğu yama mevcuttu. Ayrıca tüm el tırnak distallerinde kahverengi pigmentasyon mevcuttu. Hastanın yapılan biyopsisi fototoksik dermatit olarak değerlendirildi. Tırnaklardaki renk değişikliği fotoonikoliz olarak kabul edildi. Doksisikline bağlı hem fototoksik reaksiyon hem de fotoonikoliz gelişmesi nadir olduğu için olguyu sunmayı uygun bulduk.
References
- French LE, Prins C. Phototoxicity. Callen PJ, Horn TD, Mancini AJ, Salasche SJ, Schaffer JV, Schwarz T, Stingle G, Stone MS (eds). Dermatology. 2 nd ed. Spain:Mosby Elsevier, 2008:306-7.
- Stein KR, Scheinfeld NS. Drug-induced photoallergic and phototoxic reactions Expert Opin Drug Saf 2007;6:431-43.
- Rabar D, Combemale P, Peyron F. Doxycycline-induced photo- onycholysis. J Travel Med 2004;11:386-7.
- Layton AM, Cunliffe WJ. Phototoxic eruptions due to doxycycline—a dose related phenomenon. Clin Exp Dermatol 1993;18:425-42.
- Yong CK, Prendiville J, Peacock DL, Wong LT, Davidson AG. An unusual presentation of doxycycline-induced photosensitivity. Pediatrics 2000;106:13.
- Bonnetblanc JM. Doxycycline. Ann Dermatol Venereol 2002; 129:874-82.
- Smith EL, al Raddadi A, al Ghamdi F, Kutbi S. Tetracycline phototoxicity. Br J Dermatol 1995;132:316-7.
- Kutlubay Z, Sevim A, Engin B, Tüzün Y. Photodermatoses, including phototoxic and photoallergic reactions (internal and external). Clin Dermatol 2014;32:73-9.
- Ozkol HU, Calka O, Karadag A, Akdeniz N, Bilgili S, Behcet L. Nine case series with phototoxic dermatitis related to Chenopodium album. Hum Exp Toxicol 2012;31:964–8.
Abstract
Phototoxic dermatitis is the reaction developing in the sun-exposed areas after systemic intake of a photosensitive agent. The phototoxic reactions that develop with oral drugs resemble sun-burn. The reaction regresses with hyperpigmentation after discontinuation of the drug. Photo-onycholysis and pseudoporphyria are the rare outcomes of drug-related phototoxicity. The main drugs responsible for phototoxic reactions and photo-onycholysis are tetracyclines (particularly doxycyclin and demeclocycline), non-steroidal anti-infl ammatory drugs (propionic acid derivatives) and fl uoroquinolones. Doxycycline is a member of the tetracycline group of antibiotics that are commonly preferred for the treatment of acne vulgaris. In this paper, a 12-year-old female patient who had used rifampicine and doxycycline for brucellosis and who had developed phototoxic dermatitis is presented. There was brown discoloration in the distal part of her all hand nails. On her dermatologic examination, there was a patchy lesion which contained pale, erythematous scabs with irregular borders that were dry and adherent in some sites on her nose and cheeks. In addition, she had brown pigmentation on the distal parts of her hand nails. Biopsy was evaluated as phototoxic dermatitis. The discoloration on her nails was accepted as being photooncholysis. We presented this case due to the rarity of doxycycline-related phototoxic reactions and photo-onycholysis
References
- French LE, Prins C. Phototoxicity. Callen PJ, Horn TD, Mancini AJ, Salasche SJ, Schaffer JV, Schwarz T, Stingle G, Stone MS (eds). Dermatology. 2 nd ed. Spain:Mosby Elsevier, 2008:306-7.
- Stein KR, Scheinfeld NS. Drug-induced photoallergic and phototoxic reactions Expert Opin Drug Saf 2007;6:431-43.
- Rabar D, Combemale P, Peyron F. Doxycycline-induced photo- onycholysis. J Travel Med 2004;11:386-7.
- Layton AM, Cunliffe WJ. Phototoxic eruptions due to doxycycline—a dose related phenomenon. Clin Exp Dermatol 1993;18:425-42.
- Yong CK, Prendiville J, Peacock DL, Wong LT, Davidson AG. An unusual presentation of doxycycline-induced photosensitivity. Pediatrics 2000;106:13.
- Bonnetblanc JM. Doxycycline. Ann Dermatol Venereol 2002; 129:874-82.
- Smith EL, al Raddadi A, al Ghamdi F, Kutbi S. Tetracycline phototoxicity. Br J Dermatol 1995;132:316-7.
- Kutlubay Z, Sevim A, Engin B, Tüzün Y. Photodermatoses, including phototoxic and photoallergic reactions (internal and external). Clin Dermatol 2014;32:73-9.
- Ozkol HU, Calka O, Karadag A, Akdeniz N, Bilgili S, Behcet L. Nine case series with phototoxic dermatitis related to Chenopodium album. Hum Exp Toxicol 2012;31:964–8.
Details
| Other ID | JA77NB52DG |
|---|---|
| Journal Section | Case Report |
| Authors | |
| Publication Date | June 1, 2014 |
| Submission Date | June 1, 2014 |
| Published in Issue | Year 2014 Volume: 8 Issue: 3 |
The publication language of Turkish Journal of Pediatric Disease is English.
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