[Quinidine-induced lichenoid photodermatitis].

Quinidine-induced lichenoid photodermatitis was definitely isolated by Berger and Sesody in 1982. We had an opportunity to observe 4 cases of this striking clinical condition and encountered some particularities. Our patients (2 men and 2 women) were 60, 64, 81 and 68 years old respectively. All had a previous cardiovascular history; diabetes was also present in patient No. 2, and hypertension in patient No. 4. All patients were taking other drugs. The first patient presented with a 4-year old lichenoid eruption on the hands, associated with some degree of follicular keratosis. The second and third patients had a mixture of mainly lichenoid lesions on sun-exposed areas, but eczematous and desquamative lesions were also encountered. The fourth patient had typical lichenoid photodermatitis with occasional bullae on the arms and legs. In all patients the disease appeared or worsened in the Summer. It disappeared rapidly in 3 cases upon withdrawal of quinidine (patients No. 1 and 2) or hydroquinidine (patient No. 3), but it lasted longer in patient No. 4, with pigmented sequelae. Histological examination of the skin was consistent with a lichenoid eruption in all cases. However, an immunopathological study revealed a pemphigoid-like pattern in patients No. 1 and 2, and ovoid bodies more suggestive of lichen planus in patient No. 4. Photobiology was not performed. A review of the literature showed that the terms "lichen planus", "lichenoid", "lichenification" or "violaceus hue" were frequently encountered, and we suggest quinidine as one of the most common agents of lichenoid reaction.(ABSTRACT TRUNCATED AT 250 WORDS)