Cases reported "Dermatitis, Photoallergic"

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1/27. Photosensitivity with sulfasalazopyridine hypersensitivity syndrome.

    Five weeks after the start of treatment with an association of sulfasalazopyridine and piroxicam, a 30-year-old woman presented with an eczematous eruption in light-exposed areas, hepatomegaly and fever (38 degrees C). Laboratory studies showed leukocytosis, eosinophilia and hepatic cytolysis. Treatment consisted of withdrawing the two drugs and topical steroids. The clinical signs regressed in 6 days. An increase in eosinophilia and hepatic cytolysis was observed until the tenth day, after which the trend reversed. Laboratory parameters were normal on the twentieth day. One month later, photopatch testing was performed. A patch test with sulfanilamide irradiated with UVA was positive. Clinical and laboratory findings were highly suggestive of drug hypersensitivity syndrome. The positive result from the UVA photopatch test with sulfanilamide suggests that sulfasalazopyridine was involved in the occurrence of hypersensitivity syndrome in our patient. We conclude that photodistributed eruptions can be observed in drug hypersensitivity syndrome with photosensitizing drugs.
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2/27. Photosensitivity induced by oral itraconazole.

    A case of photosensitivity induced by itraconazole is reported. A 70-year-old woman had erythema, oedema and vesicles on sun-exposed areas after 5 days of itraconazole treatment for oral candidiasis. Oral photochallenge using itraconazole and sun irradiation was positive, but photopatch test was negative. Photosensitivity from azoles is an uncommon adverse effect. Only three other cases have been described, two induced by ketoconazole and one by itraconazole.
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3/27. Photocontact dermatitis to ketoprofen.

    A case of photocontact dermatitis from ketoprofen is described in a 19-year-old woman with a 3-day history of pruritic lesions on the right forearm. physical examination revealed a 105 x 46 mm, dark reddish lesion consisting of edematous erythema and papules on the extensor aspect of the right forearm. In photopatch testing, positive reactions to as-is (Mohrus compress [Hisamitsu Pharmaceutical Co, Inc, Tosu, japan]), ketorofen 1% in petrolatum (pet.), suprofen 1% pet., and tiaprofenic acid 1% pet. were seen. We must consider the anatomic sites on which nonsteroidal anti-inflammation medicaments are applied, as well as their effects.
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4/27. Photosensitivity induced by fibric acid derivatives and its relation to photocontact dermatitis to ketoprofen.

    BACKGROUND: Photosensitivity reactions to fibric acid derivatives are not well understood and have been rarely reported. OBJECTIVE: The aim of this study was to describe two cases of photosensitivity, one induced by fenofibrate and one by bezafibrate; to study the in vivo photosensitizing potential of these drugs; and to evaluate the possibility of cross-reactivity between fenofibrate and ketoprofen. methods: Patch and photopatch tests with fibric acid derivatives and ketoprofen were performed in the patients, in 12 normal volunteers, and in 7 patients with photopatch-proven photocontact dermatitis to ketoprofen. Phototesting studies were performed both while the patients were taking the drugs and after withdrawal of them, as well as in a group of 18 hyperlipemic volunteers without history of photosensitivity who were taking therapeutic doses of fenofibrate or bezafibrate for 2 to 3 months. RESULTS: Positive photopatch test responses to ketoprofen and to fenofibrate were obtained only in the first patient, who also had a weaker positive ordinary patch test response to the latter. Five patients photosensitized to ketoprofen also had a positive patch test to fenofibrate. Phototesting studies were abnormal in both patients but normal in all volunteers. CONCLUSION: An association between systemic photosensitivity to fenofibrate and photocontact sensitivity to ketoprofen seems to exist. The structural similarities of these chemicals favor cross-reactivity.
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5/27. Photoallergic contact dermatitis from ketoprofen induced by drug-contaminated personal objects.

    BACKGROUND: Photoallergic contact dermatitis from ketoprofen has been recognized since the mid-1980s. skin reactions have been reported to continue weeks after discontinuation of ketoprofen. One reason for this could be residual ketoprofen in the skin, which has been shown in a skin biopsy specimen. OBJECTIVE: We sought to report on 3 cases of photoallergic contact dermatitis from ketoprofen in topical anti-inflammatory gels and on relapses of dermatitis appearing after use of ketoprofen-contaminated objects. methods: We patch and photopatch tested, with standard series, the anti-inflammatory gel, ketoprofen, and its ingredients in serial dilutions and extracts of personal objects. We performed chemical investigations of personal objects with thin-layer chromatography, high-pressure liquid chromatography, and gas chromatography-mass spectrometry. RESULTS: Photoallergy was demonstrated to ketoprofen, which was detected in personal objects. CONCLUSION: Relapses of photoallergic contact dermatitis in patients photoallergic to ketoprofen can be induced by ketoprofen-contaminated objects such as bandages and slippers.
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keywords = patch test, patch
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6/27. Photocontact allergy to diallyl disulfide.

    Although phototoxic reactions to plants are common, photoallergic contact dermatitis to plants and plant products rarely occurs. Our objective was to review the importance of including diallyl disulfide in the evaluation of patients with suspected photosensitivity. Phototests for ultraviolet B, ultraviolet A, and visible light as well as patch tests and photopatch tests for 49 allergens from the new york University skin and Cancer Unit Photopatch Test Series were performed. Three patients had positive photopatch-test results to diallyl disulfide, which is the allergen in garlic. The authors conclude that although photocontact allergy to diallyl disulfide is rare, this allergen should be included in photopatch-test series.
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7/27. Contact urticaria, allergic contact dermatitis, and photoallergic contact dermatitis from oxybenzone.

    There is little literature regarding conventional patch tests and photopatch tests to oxybenzone resulting in both immediate- and delayed-type hypersensitivity reactions. A patient was patch-tested and photopatch-tested to various sunscreen chemicals. Both immediate- and delayed-type hypersensitivity reactions were observed with oxybenzone. The positive patch tests were also photoaccentuated. Oxybenzone, a common sunscreen allergen, can result in both contact urticaria and delayed-type hypersensitivity on both conventional patch testing and photopatch testing. Allergic contact dermatitis to sunscreen chemicals has traditionally included contact urticaria, allergic contact dermatitis, and photoallergic contact dermatitis. Due to the recognition of p-aminobenzoic acid (PABA) and its esters as sensitizers, the presence of benzophenones in "PABA-free" sunscreens has become more prevalent, especially in sunscreens with a sun protection factor (SPF) greater than 8. In our patient, immediate- and delayed-type hypersensitivity reactions were seen to oxybenzone (2-hydroxy-4-methoxybenzophenone, 2-benzoyl-5-methoxyphenol, benzophenone-3, Eusolex 4360, Escalol 567, EUSORB 228, Spectra-Sorb UV-9, Uvinul M-40) upon conventional patch testing and photopatch testing.
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8/27. Photosensitivity induced by quinidine sulfate: experimental reproduction of skin lesions.

    A case of quinidine sulfate-induced photodermatitis is reported. The photosensitive reaction to quinidine sulfate was reproducible in the photopatch test and after oral intake plus ultraviolet A (UVA) irradiation. Eczematous dermatitis was provoked after intradermal injection of in vitro UVA-irradiated quinidine sulfate only in the presence of patient's serum. The clinical picture and histology suggest an allergic reaction. The photobinding of quinidine sulfate to a potential carrier protein in skin or serum seems to be of crucial importance for this type of photodermatitis. quinidine sulfate is frequently used as an antiarrhythmic drug. Its potential as a photosensitizer should always be considered.
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9/27. Topical dexketoprofen as a cause of photocontact dermatitis.

    We reported on the case of a patient who developed a cutaneous eruption in a photoexposed area 1 week after a continous topical treatment with dexketoprofen (Enangel). Photopatch tests were positive for dexketoprofen, ketoprofen and piketoprofen and patch test was positive for piketoprofen. Control photopatch testing with dexketoprofen in 15 healthy volunteers was negative. Dexketoprofen, ketoprofen and piketoprofen are non-steroidal anti-inflamatory drugs (arylpropionic acid derivatives) often used as topical anti-inflammatory agents. It appears that the benzophenone moiety of their chemical structure is the cause of their photosensitivity and cross-photoreaction.
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10/27. Photoallergic contact sensitization to 6-methylcoumarin in poikiloderma of Civatte.

    A 49-year-old woman presented with asymptomatic progressive erythema, hyperpigmentation, atrophy, and telangiectasia on her neck. The clinical appearance and histopathology of the skin lesion was consistent with poikiloderma of Civatte. Photopatch-testing with our standard photoallergens yielded a positive reaction to 6-methylcoumarin, which was found in the patient's perfume. This report describes the first case in which photoallergic contact sensitization to 6-methylcoumarin may play an important role in the pathogenesis of poikiloderma of Civatte.
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