Jeong Soo Hyun, Hong Eun Hye, Park Eun Joo, Kim Kwang Joong, Kim Kwang Ho
Department of Dermatology, Hallym University Sacred Heart Hospital, Anyang, Korea.
Ann Dermatol. 2023 May;35(Suppl 1):S48-S51. doi: 10.5021/ad.21.052.
A 75-year-old male was diagnosed with idiopathic pulmonary fibrosis and treated with pirfenidone. He presented with an erythematous thick scaly patch on his face, neck, and both hands and arms. He had a history of significant exposure to sunlight without using sunscreen. All lesions were restricted to sun-exposed areas and appeared one month ago. Histopathological examination revealed necrotic keratinocytes, epidermal spongiosis, liquefaction degeneration of the basal layer, interface dermatitis, solar elastosis, and upper dermal perivascular lympho-histiocytic infiltration. Based on clinical and histopathological findings, the skin lesion could be diagnosed as photosensitive drug eruption induced by pirfenidone. Pirfenidone was discontinued for a month, and the patient was treated with oral and topical corticosteroids. Consequently, the skin lesion almost fully cleared, leaving mild postinflammatory hyperpigmentation. Although there are many reports of photosensitivity reactions to pirfenidone, dermatologists are still not familiar with this drug. Through this case presentation, clinicians should be aware of the potential phototoxic effects of pirfenidone and provide the necessary precautionary information to patients who take pirfenidone.
一名75岁男性被诊断为特发性肺纤维化，并接受了吡非尼酮治疗。他的面部、颈部以及双手和双臂出现了红斑性厚鳞屑斑块。他有大量日晒且未使用防晒霜的病史。所有皮损均局限于暴露于阳光的部位，且于1个月前出现。组织病理学检查显示角质形成细胞坏死、表皮海绵形成、基底层液化变性、界面性皮炎、日光性弹力纤维变性以及真皮上部血管周围淋巴细胞 - 组织细胞浸润。根据临床和组织病理学表现，皮肤损害可诊断为由吡非尼酮引起的光敏性药疹。停用吡非尼酮1个月，患者接受了口服和外用糖皮质激素治疗。结果，皮肤损害几乎完全消退，仅留下轻度炎症后色素沉着。尽管有许多关于吡非尼酮光敏反应的报道，但皮肤科医生对这种药物仍不熟悉。通过本病例报告，临床医生应意识到吡非尼酮潜在的光毒性作用，并向服用吡非尼酮的患者提供必要的预防信息。
