A case received in summer is as follows:Male, 24 years old, with fever, headache, sore throat and cough for 7 days. Respiratory tract infection, once a day intravenous levofloxacin injection treatment, the condition improved. Because of market research, I traveled between urban areas and streets. After 2 days, the skin became red and darker day by day, not itchy. Suspected “scarlet fever” and went to the doctor. Physical examination showed that the skin was flushed, the acupressure was not obvious, and there was no papule-like change protruding from the skin. The above skin manifestations were only seen in the exposed areas covered by half-sleeve shirts, with a clear boundary with normal skin and no Pasitia line. Superficial lymph nodes are not enlarged. There was no pallor around the mouth, no pharyngeal buccalitis-like changes in the pharynx, no enlarged tonsils, and no abnormal secretions. Pulmonary breath sounds were clear, and dry and wet squeaks were not heard. Normal heart rate, 80 beats per minute. There was no tenderness or rebound tenderness in the whole abdomen. There was no percussion pain in the bilateral kidney area. Routine blood and urine examination showed no abnormality. Chest X-ray showed only enhanced lung markings.
Based on the above condition analysis, skin changes are related to photosensitivity caused by levofloxacin. Instructed to stop levofloxacin, the upper respiratory tract infection has been almost cured, and Chuanhuning can be used for consolidation therapy. Avoid direct sunlight in the near future. After 10 days of follow-up, the patient recovered.
In the blink of an eye, it is July, the summer is hot, and photosensitivity reactions caused by drugs are gradually increasing. This article will detail the classification of drug-induced photosensitivity and the drugs that cause photosensitivity.
Drug-induced photosensitivity and its classification [1, 2]
Drug-induced photosensitivity refers to exposure to sunlight (mainly the adverse reactions to UV rays). Photosensitive reactions can be divided into phototoxic reactions and photoallergic reactions.
1. Phototoxicity
The first time the skin comes into contact with photosensitive substances or the photosensitive substances that enter the body through food or injection, it is distributed in the skin and develops after exposure, which is called phototoxic dermatitis. The light-sensitive substances we often come into contact with are cosmetics, dyes, detergents, tar, asphalt, etc.
2. Photoallergy
The first time the skin is exposed to photosensitive substances and orally administered (and injected) photosensitive substances are distributed to the skin, and dermatitis occurs after a certain incubation period (5~20 d or longer) after exposure. It’s called photoallergic dermatitis. Antihistamine drugs, some plants and some chemical drugs can be photosensitive substances in photoallergic dermatitis, and the onset of symptoms occurs within 24-48 hours after exposure to these substances again.
3. Difference[3]
Drugs that can cause photosensitivity reactions [4-11]
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Prevention and Treatment1 . Ask the medical history, patients with a history of phototoxic reactions should be cautious in using photosensitizing drugs. 2. Avoid exposure to sunlight or ultraviolet light during the use of photosensitizing drugs and for 5 days after discontinuation. 3. Susceptible people should pay special attention to skin protection when going out during the use of photosensitive drugs. If they need to go out, they can wear wide-brimmed hats or umbrellas, and apply sunscreen. 4. Use strategies such as nighttime medication. 5. In case of phototoxic reaction or skin damage, the drug with photosensitivity should be stopped immediately, and the doctor should be consulted in time. Typesetting | Eleven Round Face HeroesTitle Map | Station Cool HailuoSubmission | [email protected]
< /span>References[1]Wang Shifan, Compiler. Adverse Drug Reactions [M]. Beijing: People’s Health Publishing House, 1988: 1018.[2] Wang Shifan, Compiler. Adverse Drug Reactions [M]. Second Edition. Beijing: People’s Health Publishing House, 1996: 826.[3]Lela Lankerani, Elma D Baron.Photosensitivity to Exogenous Agents [J] . J Cutan Med and Surg, 2004, 8: 424-431.[4] Zhao Jianfeng. Study on the photosensitivity toxicity of fluoroquinolone antibiotics and its inhibitory mechanism[D]. Graduate School of Chinese Academy of Sciences (Shanghai Application) Institute of Physics), 2017[5] Huang Jia, Yang Li, Zhao Zhigang, Mei Shenghui. Sensitizing drugs and prevention of drug-induced photosensitivity reactions[J].Drug Evaluation,2014,11( 02):17-21+48. [6]Bi Guihong.Analysis of photosensitivity of quinolone antibiotics[J].China Practical Medicine,2011,6(13):202-203.[7]Wang Guangjin,Zhang Furen.Drug-induced photosensitivity[J].Chinese Journal of Dermatology and Venereology,2009,8(02):131-133.[8 ] Sheng Li, Yin Leping. Photosensitive reaction of quinolones and its prevention[J]. Chinese Journal of Hospital Pharmacy, 2007(06): 830-831.
[9] Liu Chuyang. Drugs Adverse reactions of patients with acute respiratory syndrome – photosensitivity and its prevention and treatment[J].Guangdong Pharmacy,2005(05):45-47.
[10]Wu Danwei,Xing Ying, Zhen Jiancun. Literature analysis of skin photosensitivity reaction induced by pirfenidone[J].Chinese Journal of Hospital Pharmacy,2017,37(06):538-540.
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