Di Bartolomeo Luca, Irrera Natasha, Campo Giuseppe Maurizio, Borgia Francesco, Motolese Alfonso, Vaccaro Federico, Squadrito Francesco, Altavilla Domenica, Condorelli Alessandra Grazia, Motolese Alberico, Vaccaro Mario
Department of Clinical and Experimental Medicine, Dermatology, University of Messina, Messina, Italy.
Department of Clinical and Experimental Medicine, Pharmacology, University of Messina, Messina, Italy.
Front Allergy. 2022 Jun 20;3:876695. doi: 10.3389/falgy.2022.876695. eCollection 2022.
Drug-induced photosensitivity (DIP) is a common cutaneous adverse drug reaction, resulting from the interaction of ultraviolet radiations, mostly ultraviolet A, with drugs. DIP includes phototoxicity and photoallergy. A phototoxic reaction is obtained when topical and systemic drugs or their metabolites absorb light inducing a direct cellular damage, while a photoallergic reaction takes place when the interaction between drugs and ultraviolet radiations causes an immune cutaneous response. Clinically, phototoxicity is immediate and appears as an exaggerated sunburn, whereas photoallergy is a delayed eczematous reaction. DIP may show several clinical subtypes. In this mini-review we report the pathogenetic mechanisms and causative drugs of DIP. We offer a detailed description of DIP clinical features in its classical and unusual subtypes, such as hyperpigmentation/dyschromia, pseudoporphyria, photo-onycolysis, eruptive teleangiectasia, pellagra-like reaction, lichenoid reaction, photodistributed erythema multiforme and subacute/chronic cutaneous lupus erythematosus. We described how physicians may early recognize and manage DIP, including diagnostic tests to rule out similar conditions. We made suggestions on how to improve sun exposure behaviors of patients at risk of DIP by means of an aware use of sunscreens, protective clothing and recent technologic tools. We highlighted the lack of sun safety programs addressed to patients at risk of DIP, who need a formal education about their condition.
药物性光敏反应（DIP）是一种常见的皮肤药物不良反应，由紫外线辐射（主要是紫外线A）与药物相互作用引起。DIP包括光毒性和光变态反应。当局部和全身用药或其代谢产物吸收光线导致直接的细胞损伤时，会发生光毒性反应；而当药物与紫外线辐射相互作用引起免疫性皮肤反应时，则会发生光变态反应。临床上，光毒性反应是即时性的，表现为过度晒伤，而光变态反应是一种延迟性湿疹样反应。DIP可能表现出几种临床亚型。在本综述中，我们报告了DIP的发病机制和致病药物。我们详细描述了DIP在其经典和不常见亚型中的临床特征，如色素沉着/色素异常、假性卟啉症、光甲癣、暴发性毛细血管扩张、糙皮病样反应、苔藓样反应、光分布性多形红斑以及亚急性/慢性皮肤型红斑狼疮。我们描述了医生如何早期识别和处理DIP，包括排除类似病症的诊断测试。我们就如何通过合理使用防晒霜、防护服和最新技术工具来改善DIP高危患者的日晒行为提出了建议。我们强调了针对DIP高危患者缺乏防晒安全计划的问题，这些患者需要接受关于自身病情的正规教育。
