Schauder S
From the Department of Dermatology, University of Göttingen, Göttingen, Germany.
Am J Contact Dermat. 1998 Sep;9(3):182-7.
Although photosensitivity after photoallergy to topical phenothiazine antihistamines is well known, there have been no previous reports of dioxopromethazine inducing this phenomenon.
A housewife used 0.5% dioxopromethazine in Prothanon gel for palpebral pruritus and developed severe dermatitis of the lower eyelids with spread to the sun-exposed areas.
The minimal erythema doses and the minimal infiltrate doses for ultraviolet A (UVA) and ultraviolet B (UVB) were established before photopatch testing and at intervals up to 497 days thereafter. Test sites were read up to 144 hours after irradiation. Photopatch testing was performed with Prothanon gel, dioxopromethazine hydrochloride 0.001% to 0.5%, and the standard photopatch test tray (Hermal/Trolab). For patch testing, various series of the German Contact Dermatitis Group were applied.
Minimal erythema doses for UVA were diminished before photopatch testing and at intervals up to 500 days after Prothanon gel was discontinued. Exposure to UVB provoked abnormal delayed infiltrated reactions. Clinically the photosensitivity persisted within this period. Photoallergic reactions were seen with Prothanon gel, dioxopromethazine hydrochloride 0.005% to 1.0%, and promethazine hydrochloride 0.1%. The patient gave positive patch test reactions to various fragrance materials, balsam of Peru, costus oil, and propylene glycol.
Because topical dioxopromethazine may cause photoallergic contact dermatitis followed by long-lasting photosensitivity even after contact has been discontinued, its withdrawal from the market is recommended.
尽管局部使用吩噻嗪类抗组胺药引起光过敏后的光敏反应已为人熟知，但此前尚无关于二氧丙嗪引发此现象的报道。
一名家庭主妇使用含有0.5%二氧丙嗪的普罗沙农凝胶治疗眼睑瘙痒，结果下眼睑出现严重皮炎，并蔓延至暴露于阳光下的部位。
在进行光斑贴试验前及之后长达497天的时间里，每隔一段时间测定紫外线A（UVA）和紫外线B（UVB）的最小红斑量和最小浸润量。照射后长达144小时读取试验部位情况。使用普罗沙农凝胶、0.001%至0.5%的盐酸二氧丙嗪以及标准光斑贴试验托盘（赫尔马尔/特罗实验室）进行光斑贴试验。进行斑贴试验时，应用了德国接触性皮炎研究组的各类系列产品。
在光斑贴试验前以及停用普罗沙农凝胶后长达500天的时间里，UVA的最小红斑量均降低。暴露于UVB会引发异常的延迟浸润反应。在此期间，临床上光敏反应持续存在。使用普罗沙农凝胶、0.005%至1.0%的盐酸二氧丙嗪以及0.1%的盐酸异丙嗪时出现了光过敏反应。该患者对多种香料、秘鲁香脂、木香根油和丙二醇的斑贴试验反应呈阳性。
由于局部使用二氧丙嗪可能导致光过敏性接触性皮炎，且即使在停止接触后仍会出现持久的光敏反应，因此建议将其撤出市场。
