Goetze Steven, Hiernickel Christian, Elsner Peter
Department of Dermatology, University Hospital Jena, Jena, Germany.
Skin Pharmacol Physiol. 2017;30(2):76-80. doi: 10.1159/000458761. Epub 2017 Mar 15.
One of the most important dermatologic side effects of doxycycline is photosensitivity. As doxycycline is important for malaria prophylaxis and malaria is mainly spread in countries with high sun radiation, special attention should be paid to this adverse effect. While there are many publications on the phototoxicity of tetracyclines in general, only a few exist focusing on doxycycline. The objective of this systematic review was to summarize all available reports on clinical manifestations, influencing factors like UV dose or dose of medication, and the possibilities of prevention by sun protection.
This review is based on a systematic search in PubMed for articles in English and German and a manual search between 1990 and 2015.
The number of publications is low. Clinical symptoms vary from light sunburn-like sensation (burning, erythema) to large-area photodermatitis. Also, onycholysis is possible. The triggering UV spectrum seems to consist mainly of UVA1 (340-400 nm), so UV-protective products should be used that cover this range. Travelers to tropical countries taking doxycycline for malaria prophylaxis need thorough medical counseling to avoid possibly severe phototoxic reactions.
Evidence base must be improved for giving advice on appropriate prevention measures to travelers taking doxycycline and having a risk of significant sun exposure.
强力霉素最重要的皮肤副作用之一是光敏性。由于强力霉素对疟疾预防很重要，而疟疾主要在阳光辐射强烈的国家传播，因此应特别关注这种不良反应。虽然关于四环素类药物的光毒性总体上有很多出版物，但专门针对强力霉素的却很少。本系统评价的目的是总结所有关于临床表现、紫外线剂量或药物剂量等影响因素以及防晒预防可能性的现有报告。
本评价基于对PubMed中英语和德语文章的系统检索以及1990年至2015年的手工检索。
出版物数量较少。临床症状从轻微的晒伤样感觉（灼痛、红斑）到大面积光性皮炎不等。此外，还可能出现甲床分离。引发的紫外线光谱似乎主要由UVA1（340 - 400纳米）组成，因此应使用覆盖该范围的防晒产品。前往热带国家服用强力霉素预防疟疾的旅行者需要接受全面的医疗咨询，以避免可能出现的严重光毒性反应。
对于为服用强力霉素且有大量阳光暴露风险的旅行者提供适当预防措施的建议，必须改进证据基础。
