Photosensitivity

Some of you may recognise this cartoon from last Saturday's Star

It's John McPherson's play on the side effect of certain drugs.

Drug-Induced Photosensitivity

Photosensitvity is inflammation of the skin induced by the combination of sunlight and certain medications or substances. This causes redness (erythema) of the skin and make look similar to sunburn. Drug-induced photosensitivity or photosensitising medications can cause unexpected sunburn or a dry, bumpy or blistering rash on sun-exposed skin (face, neck, arms, backs of hands and often lower legs and feet). The rash may or may not be itchy.

What are some common photosensitizing drugs?

Common photosensitizing drugs include the following:

Antibiotics

- the quinolones [for example, ciprofloxacin (Bactiflox, Ciloxan, Ciprobay),

- levofloxacin tetracyclines [for example, tetra, doxycycl (Doline, Doxycylin, Vibramycin)

- sulfonamides [for example, sulfamethoxazole and trimethoprim (Bactrim, Cotrim, Trimexazole)

Antihistamines

- diphenhydramine (Benadryl)

Malaria medications

- quinine (Quinerva, Quinite, QM-260)

- chloroquine (Aralen)

- hydroxychloroquine (Plaquenil)

Cancer chemotherapy drugs

- 5-fluorouracil (5-FU, Efudex, Carac, Fluoroplex)

- vinblastine (Velban, Velsar)

- dacarbazine (DTIC-Dome)

Cardiac drugs

- amiodarone (Aratac, Cordarone)

- nifedipine (Adalat, Cordipin)

- quinidine (Quinaglute, Quinidex)

- diltiazem (Cardil, Dilem, herbesser)

Diuretics

- furosemide (Lasix)

- thiazides [hydrochlorothiazide (HCT)

Diabetic drugs

- sulfonylureas [chlorpropamide (Diabinese), glyburide (Micronase, DiaBeta, Glynase)]

Painkillers

- non-steroidal antiinflammatory drugs [naproxen (Naprosyn, Naprelan, Anaprox, Aleve), piroxicam (Feldene)

Skin medications

- photodynamic therapy for skin cancer [ALA or 5-aminolevulinic acid (Levulan), Methyl-5-aminolevulinic acid)

Acne medications

- isotretinoin (Accutane)

- acitretin (Soriatane)

Psychiatric drugs

- phenothiazines [chlorpromazine (Matcine)]

- tricyclic antidepressants [desipramine (Norpramin), imipramine (Apo-Imipramine, Tofranil)

Is anyone taking these drugs at risk for developing sunburn?

It is important to realize that not everyone taking any of these drugs will develop photosensitivity reactions. Certain individuals have more susceptibility to these medications than others.

Can any foods or plants cause photosensitivity reactions?

Some vegetables and plants may cause sun sensitivity if they come into contact with the skin. Mango peel, lime juice, parsnips, or celery, for example, may cause temporary discoloration (darkening) of the skin contact area when in the sun. Common phototoxic fruits and vegetables include:

- Lime

- Celery

- Carrots

- Figs

- Parsley

- Parsnips

For further information, please speak to our pharmacist or visit dermnetnz.org