Department of Medical Sciences, Section of Dermatology and Infectious Diseases, University of Ferrara, Ferrara, Italy.
Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
Dermatol Ther. 2021 Jul;34(4):e14978. doi: 10.1111/dth.14978. Epub 2021 May 24.
Tetracyclines are a group of broad-spectrum antibiotics largely employed in infectious, dermatological and surgical fields. Some adverse events may occur during treatment, including photosensitivity reactions, which are divided in phototoxic or photoallergic. We performed a systematic search on Pubmed, Cochrane and Embase from database inception to August 9, 2020 aim to summarize all available papers on photosensitive reactions related to tetracyclines in all clinical settings where they are used on human being. On the basis of our inclusion criteria, we selected only randomized controlled trials, open comparative trials and prospective cohort studies performed on both volunteers and patients, moreover we included a pharmacovigilance register. Thirty-eight articles met inclusion criteria, describing photo-sensitive effects due to doxycycline, minocycline, tetracycline, lymecycline, sarecycline, demethylchlortetracycline, chlortetracycline and metacycline, across six diagnoses (acne, Lyme disease, Gulf Veteran Illness, adbominal aortic aneurysms, traveler's diarrhea and pterygium) and several volunteers who were deliberately exposed to natural or artificial light sources. Not all drugs belonging to tetracyclines class are available to date, moreover the studies included lacked a homogeneous design and most of them involved a scarce number of patients, including reactions induced in volunteers during photo-testing. Available data on incidence, severity and clinical relevance of tetracyclines-related photo-sensitive reactions are scarce, heterogeneous and weak. What we can extrapolate is that some tetracyclines are more often related to phototoxic skin reactions than others and some of those seem to have a very low risk of phototoxicity.
四环素类抗生素是一类广谱抗生素，主要用于感染、皮肤科和外科领域。在治疗过程中可能会出现一些不良反应，包括光过敏反应，可分为光毒性或光变态反应。我们在 Pubmed、Cochrane 和 Embase 上进行了系统检索，检索时间从数据库建立到 2020 年 8 月 9 日，旨在总结所有关于人类临床应用四环素类药物相关光过敏反应的可用文献。根据我们的纳入标准，我们仅选择了随机对照试验、开放对照试验和前瞻性队列研究，这些研究对象包括志愿者和患者，并且还包括药物警戒登记。有 38 篇文章符合纳入标准，描述了因多西环素、米诺环素、四环素、二甲胺四环素、沙雷环素、去甲氯四环素、金霉素和甲烯土霉素引起的光敏感效应，涉及六个诊断（痤疮、莱姆病、海湾老兵病、腹主动脉瘤、旅行者腹泻和翼状胬肉）和一些志愿者，他们故意暴露在自然光或人工光源下。目前并非所有属于四环素类的药物都有，而且纳入的研究设计缺乏一致性，大多数研究只涉及少数患者，包括在光试验中诱导志愿者产生的反应。有关四环素类药物相关光过敏反应的发生率、严重程度和临床相关性的数据很少、异质性强且证据薄弱。我们可以推断出，一些四环素类药物比其他药物更容易引起光毒性皮肤反应，而且其中一些似乎光毒性风险非常低。
