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Review on photoprotection: a clinician’s guide to the ingredients, characteristics, adverse effects, and disease-specific benefits of chemical and physical sunscreen compounds. Arch Dermatol Res 2022; 315:735-749. [PMID: 36443500 DOI: 10.1007/s00403-022-02483-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 09/15/2022] [Accepted: 11/15/2022] [Indexed: 11/29/2022]
Abstract
Photoprotection is a critical health prevention strategy to reduce the deleterious effects of ultraviolet radiation (UVR) and visible light (VL). Methods of photoprotection are reviewed in this paper, with an emphasis on sunscreen. The most appropriate sunscreen formulation for personal use depends on several factors. Active sunscreen ingredients vary in their protective effect over the UVR and VL spectrum. There are dermatologic diseases that cause photosensitivity or that are aggravated by a particular action spectrum. In these situations, sunscreen suggestions can address the specific concern. Sunscreen does not represent a single entity. Appropriate personalized sunscreen selection is critical to improve compliance and clinical outcomes. Health care providers can facilitate informed product selection with awareness of evolving sunscreen formulations and counseling patients on appropriate use. This review aims to summarize different forms of photoprotection, discuss absorption of sunscreen ingredients, possible adverse effects, and disease-specific preferences for chemical, physical or oral agents that may decrease UVR and VL harmful effects.
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Sunscreens: A Review of UV Filters and Their Allergic Potential. Dermatitis 2022; 34:176-190. [DOI: 10.1097/der.0000000000000963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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3
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Götzinger F, Reichrath J, Millenaar D, Lauder L, Meyer MR, Böhm M, Mahfoud F. Photoinduced skin reactions of cardiovascular drugs-a systematic review. EUROPEAN HEART JOURNAL. CARDIOVASCULAR PHARMACOTHERAPY 2022; 8:420-430. [PMID: 35278085 DOI: 10.1093/ehjcvp/pvac017] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/10/2022] [Accepted: 03/09/2022] [Indexed: 06/14/2023]
Abstract
This systemic review aims to provide a practical overview of the prevalence, clinical manifestation, and management of adverse photoinduced skin reactions caused by frequently used cardiovascular drugs and to assess their potential relevance for skin cancer development. Data search included PubMed, Web of Science, and the Cochrane Library. A systematic review of peer-reviewed studies reporting the photosensitizing and/or skin cancer-inducing properties of common cardiovascular drugs was performed and a guide to clinical management of photoinduced skin eruptions by cardiovascular drugs was provided. Study quality was assessed for major methodological biases. A total of 58 studies were identified (i.e. 23 case reports, 14 observational studies, 10 review articles, 10 experimental studies, and 1 meta-analysis). Most commonly, drug-associated adverse photoinduced cutaneous reactions were caused by phototoxic and photoallergic mechanisms. There is evidence suggesting that amiodarone and dronedarone, thiazide diuretics, thiazide-like diuretics, angiotensin receptor blockers, dihydropyridine-type calcium channel blockers, and certain angiotensin-converting enzyme inhibitors and statins may cause photoinduced adverse cutaneous reactions. Other drugs such as anticoagulants, antiplatelets, aldosterone antagonists, and fibrates have not been linked with photosensitizing reactions or adverse cutaneous reactions. Some drugs, i.e. thiazides and thiazide-like diuretics, were associated with an increased risk of non-melanoma skin cancers (basal cell carcinoma and squamous cell carcinoma). Certain commonly used cardiovascular drugs have been associated with adverse photoinduced cutaneous reactions. If they occur, further diagnosis and treatment might be needed, depending on the severity and progress. Whether photosensitizing drugs increase the risk of skin cancer remains elusive and further randomized controlled trials are required.
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Affiliation(s)
- Felix Götzinger
- Department of Internal Medicine III, Cardiology, Angiology and Intensive Care Medicine, University Hospital Saarland, Saarland University, Geb. 41, Kirrbergerstraβe 100, 66424 Homburg, Germany
| | - Jörg Reichrath
- Department of Adult and Pediatric Dermatology, Venereology, Allergology, University Hospital Saarland, Saarland University, 66424 Homburg, Germany
| | - Dominic Millenaar
- Department of Internal Medicine III, Cardiology, Angiology and Intensive Care Medicine, University Hospital Saarland, Saarland University, Geb. 41, Kirrbergerstraβe 100, 66424 Homburg, Germany
| | - Lucas Lauder
- Department of Internal Medicine III, Cardiology, Angiology and Intensive Care Medicine, University Hospital Saarland, Saarland University, Geb. 41, Kirrbergerstraβe 100, 66424 Homburg, Germany
| | - Markus R Meyer
- Department of Experimental and Clinical Toxicology, Institute of Experimental and Clinical Pharmacology and Toxicology, Center for Molecular Signaling (PZMS), Saarland University, 66421 Homburg, Germany
| | - Michael Böhm
- Department of Internal Medicine III, Cardiology, Angiology and Intensive Care Medicine, University Hospital Saarland, Saarland University, Geb. 41, Kirrbergerstraβe 100, 66424 Homburg, Germany
| | - Felix Mahfoud
- Department of Internal Medicine III, Cardiology, Angiology and Intensive Care Medicine, University Hospital Saarland, Saarland University, Geb. 41, Kirrbergerstraβe 100, 66424 Homburg, Germany
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El-Yazbi AF, Khalil HA, Belal TS, El-Kimary EI. Inexpensive bioluminescent genosensor for sensitive determination of DNA damage induced by some commonly used sunscreens. Anal Biochem 2022; 651:114700. [DOI: 10.1016/j.ab.2022.114700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 04/22/2022] [Accepted: 04/26/2022] [Indexed: 11/01/2022]
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Lee CN, Chen TY, Wong TW. The Immunogenetics of Photodermatoses. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1367:369-381. [DOI: 10.1007/978-3-030-92616-8_14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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6
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Hofmann GA, Weber B. Drug-induced photosensitivity: culprit drugs, potential mechanisms and clinical consequences. J Dtsch Dermatol Ges 2021; 19:19-29. [PMID: 33491908 PMCID: PMC7898394 DOI: 10.1111/ddg.14314] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 05/09/2020] [Indexed: 12/30/2022]
Abstract
Drug‐induced photosensitivity, the development of phototoxic or photoallergic reactions due to pharmaceuticals and subsequent exposure to ultraviolet or visible light, is an adverse effect of growing interest. This is illustrated by the broad spectrum of recent investigations on the topic, ranging from molecular mechanisms and culprit drugs through epidemiological as well as public health related issues to long‐term photoaging and potential photocarcinogenic consequences. The present review summarizes the current state of knowledge on the topic while focusing on culprit drugs and long‐term effects. In total, 393 different drugs or drug compounds are reported to have a photosensitizing potential, although the level of evidence regarding their ability to induce photosensitive reactions varies markedly among these agents. The pharmaceuticals of interest belong to a wide variety of drug classes. The epidemiological risk associated with the use of photosensitizers is difficult to assess due to under‐reporting and geographical differences. However, the widespread use of photosensitizing drugs combined with the potential photocarcinogenic effects reported for several agents has major implications for health and safety and suggests a need for further research on the long‐term effects.
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Affiliation(s)
- Georg Amun Hofmann
- Disease Modeling and Organoid Technology (DMOT) research group, Department of Dermatology, Medical University of Vienna, Austria
| | - Benedikt Weber
- Disease Modeling and Organoid Technology (DMOT) research group, Department of Dermatology, Medical University of Vienna, Austria
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Kowalska J, Rok J, Rzepka Z, Wrześniok D. Drug-Induced Photosensitivity-From Light and Chemistry to Biological Reactions and Clinical Symptoms. Pharmaceuticals (Basel) 2021; 14:723. [PMID: 34451820 PMCID: PMC8401619 DOI: 10.3390/ph14080723] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/23/2021] [Accepted: 07/24/2021] [Indexed: 02/07/2023] Open
Abstract
Photosensitivity is one of the most common cutaneous adverse drug reactions. There are two types of drug-induced photosensitivity: photoallergy and phototoxicity. Currently, the number of photosensitization cases is constantly increasing due to excessive exposure to sunlight, the aesthetic value of a tan, and the increasing number of photosensitizing substances in food, dietary supplements, and pharmaceutical and cosmetic products. The risk of photosensitivity reactions relates to several hundred externally and systemically administered drugs, including nonsteroidal anti-inflammatory, cardiovascular, psychotropic, antimicrobial, antihyperlipidemic, and antineoplastic drugs. Photosensitivity reactions often lead to hospitalization, additional treatment, medical management, decrease in patient's comfort, and the limitations of drug usage. Mechanisms of drug-induced photosensitivity are complex and are observed at a cellular, molecular, and biochemical level. Photoexcitation and photoconversion of drugs trigger multidirectional biological reactions, including oxidative stress, inflammation, and changes in melanin synthesis. These effects contribute to the appearance of the following symptoms: erythema, swelling, blisters, exudation, peeling, burning, itching, and hyperpigmentation of the skin. This article reviews in detail the chemical and biological basis of drug-induced photosensitivity. The following factors are considered: the chemical properties, the influence of individual ranges of sunlight, the presence of melanin biopolymers, and the defense mechanisms of particular types of tested cells.
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Affiliation(s)
| | | | | | - Dorota Wrześniok
- Department of Pharmaceutical Chemistry, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, Jagiellońska 4, 41-200 Sosnowiec, Poland; (J.K.); (J.R.); (Z.R.)
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Hofmann GA, Weber B. Medikamenten‐induzierte Photosensibilität: auslösende Medikamente, mögliche Mechanismen und klinische Folgen. J Dtsch Dermatol Ges 2021; 19:19-30. [PMID: 33491893 DOI: 10.1111/ddg.14314_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 05/09/2020] [Indexed: 12/01/2022]
Affiliation(s)
- Georg Amun Hofmann
- Forschungsgruppe Disease Modeling and Organoid Technology (DMOT), Universitätsklinik für Dermatologie, Medizinische Universität Wien, Wien, Österreich
| | - Benedikt Weber
- Forschungsgruppe Disease Modeling and Organoid Technology (DMOT), Universitätsklinik für Dermatologie, Medizinische Universität Wien, Wien, Österreich
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Reviewing the effects of thiazide and thiazide-like diuretics as photosensitizing drugs on the risk of skin cancer. J Hypertens 2020; 37:1950-1958. [PMID: 31145177 DOI: 10.1097/hjh.0000000000002136] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Thiazide diuretics and particularly hydrochlorothiazide were recently linked to an increased risk of skin cancer, which was attributed to the photosensitizing properties of these drugs. Given the widespread use of thiazide diuretics, a potential skin cancer promoting effect would impose an important public health concern. OBJECTIVE To critically appraise in a narrative review, the association between use of thiazide and thiazide-like diuretics and risk of skin cancer. METHODS We evaluated chemical structures and photosensitizing potential of selected thiazide and thiazide-like diuretics. Moreover, we searched PubMed up to December 2018 for observational studies assessing the association between use of thiazide or thiazide-like diuretics and risk of skin cancer. Study quality was assessed for major methodological biases. RESULTS Commonly used thiazide and thiazide-like diuretics carry resonating structural components, such as sulfonamide groups that contribute to their photosensitizing activity. Overall, 13 observational (9 case-control, 4 cohort) studies assessed the association between use of different thiazide or thiazide-like diuretics and risk of several skin cancer types. Of those, nine studies showed positive associations ranging from 3% increased risk for bendroflumethiazide and basal cell carcinoma to 311% increased risk for thiazide diuretics and squamous cell carcinoma. All studies had important design-related methodological limitations including potential confounding by indication, detection bias, and time-window bias. CONCLUSION Commonly used thiazide and thiazide-like diuretics have photosensitizing potential, and some observational studies with important methodological limitations have linked their use to an increased risk of skin cancer. Well designed observational studies are needed to provide more solid evidence on this possible association.
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Rozas-Muñoz E, Game D. Allergic Contact Dermatitis of the Face: a Review of the Common Agents Involved and Differential Diagnosis. CURRENT TREATMENT OPTIONS IN ALLERGY 2020. [DOI: 10.1007/s40521-020-00262-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Eljaaly K, Alkhalaf A, Alhifany AA, Alshibani M. Photosensitivity induced by lomefloxacin versus other fluoroquinolones: A meta-analysis. J Infect Chemother 2020; 26:535-539. [PMID: 32081646 DOI: 10.1016/j.jiac.2020.01.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2019] [Revised: 01/08/2020] [Accepted: 01/21/2020] [Indexed: 12/12/2022]
Abstract
Lomefloxacin may be more likely than other fluoroquinolones to cause photosensitivity. However, the rate of photosensitivity is variable and a meta-analysis has yet to be performed. The aim of this meta-analysis is to compare the rate of photosensitivity between outpatients who received lomefloxacin and those who received other fluoroquinolones. PubMed, EMBASE, Cochrane Library databases and trial registries were searched for randomized controlled trials (RCTs) of outpatients through June 12, 2019. The study outcome was the rate of photosensitivity based on the intention-to-treat principle, estimated by risk difference (RD) as the primary analysis and Peto odds ratio (Peto OR) as the secondary analysis, with 95% confidence intervals (CIs) using random-effects models. Four RCTs (total of 2295 patients) were included in this meta-analysis. A statistically higher risk of photosensitivity was found with lomefloxacin than with other fluoroquinolones (RD, 3.4%; 95% CI, 0.7%-6.2%; P-value = 0.013; I2 = 10.9%). The odds of photosensitivity was also significantly higher with lomefloxacin (Peto OR, 5.81; 95% CI, 3.34 to 10.11; P-value <0.001; I2 = 0%). This meta-analysis of RCTs found significantly higher photosensitivity with lomefloxacin compared to other fluoroquinolones. Considering this finding and given its lack of additional efficacy compared to other fluoroquinolones, lomefloxacin as a fluoroquinolone option should potentially be reconsidered.
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Affiliation(s)
- Khalid Eljaaly
- Department of Pharmacy Practice, College of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia; Pharmacy Practice and Science Department, College of Pharmacy, University of Arizona, Tucson, AZ, USA.
| | - Amina Alkhalaf
- Department of Pharmacy Practice, College of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdullah A Alhifany
- Clinical Pharmacy Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Mohannad Alshibani
- Department of Pharmacy Practice, College of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia; Pharmacy Practice and Science Department, College of Pharmacy, University of Arizona, Tucson, AZ, USA
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12
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Yin Y, Qiu XY, Zhang YH, Zhang B. A rare cutaneous phototoxic rash after vandetanib therapy in a patient with thyroid cancer: A case report. Medicine (Baltimore) 2019; 98:e16392. [PMID: 31374006 PMCID: PMC6709084 DOI: 10.1097/md.0000000000016392] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
RATIONALE Vandetanib is effective for treating symptomatic or progressive medullary thyroid cancer (MTC) in patients with unresectable locally advanced or metastatic disease, but its toxicity such as photosensitivity reactions should be considered. It is a rare adverse effect of this drug but might cause severe morbidity and even mortality. PATIENT CONCERNS A 26-year man with MTC developed phototoxic rashes on the sun-exposed areas of his shin after 15 days from the initiation of vandetanib treatment. Grade II skin toxicity was evaluated based on the Common Terminology Criteria for Adverse Events standard. DIAGNOSES Drug-induced phototoxic rash. INTERVENTIONS The vandetanib dose was reduced by 30%, and the application of topical steroids and sunscreen was adopted. OUTCOMES After dose reduction of vandetanib, the symptoms of vandetanib-induced phototoxic rash resolved, although residual pigmentation was observed. LESSONS Close attention should be paid to the adverse effect of vandetanib, phototoxic rash, and patients should be advised on the prevention and treatment measures.
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Affiliation(s)
- Yue Yin
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Pharmacy
| | - Xin Ye Qiu
- Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Yan Hua Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Pharmacy
| | - Bin Zhang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Head and Neck Surgery, Peking University Cancer Hospital and Institute
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Photoallergic dermatitis associated with fixed-dose combination of antiretroviral agent (abacavir-lamivudine-dolutegravir). AIDS 2018; 32:1385-1388. [PMID: 29851666 DOI: 10.1097/qad.0000000000001838] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Abstract
Cutaneous adverse drug reactions comprise a significant proportion of all adverse drug reactions. They may mimic other dermatologic or systemic illnesses and may cause significant morbidity or mortality. Seven morphologic groups encompass the most commonly encountered cutaneous drug reaction syndromes: exanthematous (maculopapular), dermatitic/eczematous, urticarial, pustular, blistering, purpuric, and erythrodermic. Drug reactions may have significant downstream consequences for the older individual.
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Hossy BH, da Costa Leitão AA, dos Santos EP, Matsuda M, Rezende LB, Rurr JSC, Pinto AV, Ramos-e-Silva M, de Pádula M, de Oliveira Miguel NC. Phototoxic assessment of a sunscreen formulation and its excipients: An in vivo and in vitro study. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2017; 173:545-550. [DOI: 10.1016/j.jphotobiol.2017.06.043] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 06/27/2017] [Accepted: 06/28/2017] [Indexed: 11/25/2022]
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16
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Comparative assessment of local tolerance of alcohols commonly used in alcohol-based hand rubs for hand hygiene. Toxicol In Vitro 2017; 44:142-153. [PMID: 28700953 DOI: 10.1016/j.tiv.2017.07.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 07/05/2017] [Accepted: 07/07/2017] [Indexed: 11/21/2022]
Abstract
Hand hygiene plays a key role in nosocomial infection prevention. To achieve users' adherence, products' dermal tolerance is essential. We aimed at making a comparative assessment of skin irritation and phototoxicity of the 3 alcohols commonly used in alcohol-based hand rubs (Ethanol, Propan-2-ol, Propan-1-ol) at 60, 70, 80 or 85% w/w in water or with co-formulates (hydrating, emollient and skin protective agents). In vitro validated OECD methods 439 and 432 were used. For irritation, EpiSkin™ Small Model was the chosen Reconstructed Human Epidermis (RhE). For phototoxicity, co-formulates alone or in mixture with and without alcohol were tested using BALB/c 3T3 cell cultures. Whilst Ethanol and Propan-2-ol could not be differentiated and displayed good skin tolerance profiles, Propan-1-ol based products lead to significant viability impairments of RhE at 60, 70 or 80% and at 60% in the presence of co-formulates. However, these results could not be reproduced in another RhE model. Taking also into account bibliographic data on Propan-1-ol, this suggests that our results are probably related to a lack of specificity of the used RhE. Therefore, it can be relevant in case of significant results to use two different RhE models before performing any classification and/or performing any complementary tests.
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Abstract
Objective: To better understand cutaneous photosensitivity reactions, a review of its etiologic factors, clinical characteristics, pathogenesis, and treatment modalities was undertaken. Methods: Articles discussing the above aspects of phototoxic and photoallergic reactions were used to demonstrate what is currently known about photoinduced reactions and how to treat them. Results: Upon interaction of solar UV radiation with the chemical that is present in significant levels on the skin, one of two known reactions may occur in susceptible patients: a phototoxicity and/or photoallergy. Phototoxic and photoallergic reactions can be diagnosed separately on the basis of pathogenesis, clinical characteristics, and histology. Examples of drugs capable of inducing a phototoxic reaction include amiodarone, retinoids, nonsteroidal antiinflammatory agents, diuretics, and antibiotics. Substances known to cause a photoallergic response are fragrances, sunscreens, topical antimicrobials, NSAID, and psychiatric medications, such as chlorpromezine. Conclusion: Photoinduced reactions produced by exogenous chemicals are common skin disorders. Definitive therapy requires identifying and removing the offending agent, either the photosensitizing chemical or light. The use of fully protective clothing and a sunscreen of high SPF are important measures when light exposure is inevitable.
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Affiliation(s)
- Lela Lankerani
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio, USA
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18
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Gruber-Wackernagel A, Byrne SN, Wolf P. Polymorphous light eruption: clinic aspects and pathogenesis. Dermatol Clin 2015; 32:315-34, viii. [PMID: 24891054 DOI: 10.1016/j.det.2014.03.012] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Polymorphous light eruption is an immunologically mediated photodermatosis with high prevalence, particularly among young women in temperate climates, characterized by pruritic skin lesions of variable morphology, occurring in spring or early summer on sun-exposed body sites. A resistance to ultraviolet radiation (UVR)-induced immunosuppression and a subsequent delayed-type hypersensitivity response to a photoantigen have been suggested as key factors in the disease. Molecular and immunologic disturbances associated with disease pathogenesis include a failure of skin infiltration by neutrophils and other regulatory immune cells on UVR exposure linked to a disturbed cytokine microenvironment. Standard management is based on prevention.
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Affiliation(s)
- Alexandra Gruber-Wackernagel
- Research Unit for Photodermatology, Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, Graz A-8036, Austria
| | - Scott N Byrne
- Cellular Photoimmunology Group, Infectious Diseases and Immunology, Department of Dermatology, Sydney Medical School, Royal Prince Alfred Hospital, The University of Sydney, 676, Blackburn Building D06, Darlington, New South Wales 2006, Australia
| | - Peter Wolf
- Research Unit for Photodermatology, Department of Dermatology, Medical University of Graz, Auenbruggerplatz 8, Graz A-8036, Austria.
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20
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Bissonnette R, Nigen S, Bolduc C. Influence of the quantity of sunscreen applied on the ability to protect against ultraviolet-induced polymorphous light eruption. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2012; 28:240-3. [DOI: 10.1111/j.1600-0781.2012.00678.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Simon Nigen
- Innovaderm Research Inc.; Montreal; QC; Canada
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21
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JAAD grand rounds. Erythematous macules and crusted erosions in sun-exposed areas. J Am Acad Dermatol 2012; 66:862-3. [PMID: 22507582 DOI: 10.1016/j.jaad.2010.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Revised: 09/22/2010] [Accepted: 10/12/2010] [Indexed: 11/23/2022]
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22
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Maddodi N, Jayanthy A, Setaluri V. Shining light on skin pigmentation: the darker and the brighter side of effects of UV radiation. Photochem Photobiol 2012; 88:1075-82. [PMID: 22404235 DOI: 10.1111/j.1751-1097.2012.01138.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The term barrier function as applied to human skin often connotes the physical properties of this organ that provides protection from its surrounding environment. This term does not generally include skin pigmentation. However, skin pigmentation, which is the result of melanin produced in melanocytes residing in the basal layer of the skin and exported to the keratinocytes in the upper layers, serves equally important protective function. Indeed, changes in skin pigmentation are often the most readily recognized indicators of exposure of skin to damaging agents, especially to natural and artificial radiation in the environment. Several recent studies have shed new light on (1) the mechanisms involved in selective effects of subcomponents of UV radiation on human skin pigmentation and (2) the interactive influences between keratinocytes and melanocytes, acting as "epidermal melanin unit," that manifest as changes in skin pigmentation in response to exposure to various forms of radiation. This article provides a concise review of our current understanding of the effects of the nonionizing solar radiation, at cellular and molecular levels, on human skin pigmentation.
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Affiliation(s)
- Nityanand Maddodi
- Department of Dermatology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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23
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Fourtanier A, Moyal D, Seite S. UVA filters in sun-protection products: regulatory and biological aspects. Photochem Photobiol Sci 2012; 11:81-9. [DOI: 10.1039/c1pp05152k] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Son YM, Roh JY, Cho EK, Lee JR. Photosensitivity reactions to vandetanib: redevelopment after sequential treatment with docetaxel. Ann Dermatol 2011; 23:S314-8. [PMID: 22346266 PMCID: PMC3276785 DOI: 10.5021/ad.2011.23.s3.s314] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2010] [Revised: 01/11/2011] [Accepted: 01/21/2011] [Indexed: 11/08/2022] Open
Abstract
Vandetanib (ZD6474, Zactima™) is a novel, orally available inhibitor of different intracellular signaling pathways involved in tumor growth, progression, and angiogenesis, including vascular endothelial growth factor receptor-2, epidermal growth factor receptor, and rearranged during transfection tyrosine kinase activity. The most frequently reported adverse events attributed to vandetanib include diarrhea, elevated aminotransferase, asymptomatic corrected QC interval prolongation, and hypertension. In a few randomized, double-blinded studies, cutaneous adverse events including these general symptoms have been reported, but there are only a few reports on the photosensitivity reaction to vandetanib domestically as conducted by dermatologists. In this report, we describe two cases of photosensitivity reactions induced by vandetanib. After improvement with steroid and antihistamine, the photosensitivity reaction was redeveloped by sequential treatment with docetaxel.
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Affiliation(s)
- Young-Min Son
- Department of Dermatology, Gachon University of Medicine and Science, Gil Hospital, Incheon, Korea
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Tan KR, Magill AJ, Parise ME, Arguin PM. Doxycycline for malaria chemoprophylaxis and treatment: report from the CDC expert meeting on malaria chemoprophylaxis. Am J Trop Med Hyg 2011; 84:517-31. [PMID: 21460003 PMCID: PMC3062442 DOI: 10.4269/ajtmh.2011.10-0285] [Citation(s) in RCA: 118] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Doxycycline, a synthetically derived tetracycline, is a partially efficacious causal prophylactic (liver stage of Plasmodium) drug and a slow acting blood schizontocidal agent highly effective for the prevention of malaria. When used in conjunction with a fast acting schizontocidal agent, it is also highly effective for malaria treatment. Doxycycline is especially useful as a prophylaxis in areas with chloroquine and multidrug-resistant Plasmodium falciparum malaria. Although not recommended for pregnant women and children < 8 years of age, severe adverse events are rarely reported for doxycycline. This report examines the evidence behind current recommendations for the use of doxycycline for malaria and summarizes the available literature on its safety and tolerability.
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Affiliation(s)
- Kathrine R Tan
- Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, 4770 Buford Hwy., Atlanta, GA 30341, USA.
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Musa KAK, Eriksson LA. Theoretical Assessment of Norfloxacin Redox and Photochemistry. J Phys Chem A 2009; 113:10803-10. [DOI: 10.1021/jp904671s] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Klefah A. K. Musa
- Örebro Life Science Center, School of Science and Technology, Örebro University, 701 82 Örebro, Sweden, and School of Chemistry, National University of Ireland, Galway, Ireland
| | - Leif A. Eriksson
- Örebro Life Science Center, School of Science and Technology, Örebro University, 701 82 Örebro, Sweden, and School of Chemistry, National University of Ireland, Galway, Ireland
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Verdel B, Souverein P, Meyboom R, Kardaun S, Leufkens H, Egberts A. Risk of drug-induced photosensitivity: focus on spectroscopic and molecular characteristics. Pharmacoepidemiol Drug Saf 2009; 18:602-9. [DOI: 10.1002/pds.1760] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Fujimoto N, Danno K, Wakabayashi M, Uenishi T, Tanaka T. Photosensitivity with eosinophilia due to ambroxol and UVB. Contact Dermatitis 2009; 60:110-3. [DOI: 10.1111/j.1600-0536.2008.01470.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Katsarou A, Makris M, Zarafonitis G, Lagogianni E, Gregoriou S, Kalogeromitros D. Photo Allergic Contact Dermatitis: The 15-Year Experience of a Tertiary Reference Center in a Sunny Mediterranean City. Int J Immunopathol Pharmacol 2008; 21:725-7. [DOI: 10.1177/039463200802100327] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Photoallergic contact dermatitis (PACD) represents an important entity of photodermatoses while photopatch testing is the main diagnostic tool. The main goal of this study is to evaluate retrospectively the prevalence of photoallergic reactions and the offending agents in Athens during a 15-year period. The medical records of all patients with possible PACD between 1992 and 2006 were examined. All patients included in the analysis had undergone patch testing and photo-testing. Contact reactions were detected in 86 out of 207 participants (41.54%), while photocontact reactions were identified in 28/207 (13.52%) patients. The most common offending photoallergen was promethazine (25%), while chlorpromazine and oxybenzone were both detected in 12.5% of cases. PACD represents a unique proportion of photodermatoses in a sunny Mediterranean city such as Athens.
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Affiliation(s)
| | - M. Makris
- Allergy Unit, 2nd Dept of Dermatology and Venereology, “Attikon” University Hospital, Medical school, University of Athens, Greece
| | | | | | | | - D. Kalogeromitros
- Allergy Unit, 2nd Dept of Dermatology and Venereology, “Attikon” University Hospital, Medical school, University of Athens, Greece
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Tamura A, An R, Hagiya Y, Hoshijima K, Yoshida T, Mikuriya K, Ishikawa T. Drug-induced phototoxicity evoked by inhibition of human ABC transporter ABCG2: development ofin vitrohigh-speed screening systems. Expert Opin Drug Metab Toxicol 2008; 4:255-72. [DOI: 10.1517/17425255.4.3.255] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Murali MR, Mackool BT, Muse VV, Zembowicz A, Ferry JA. Case records of the Massachusetts General Hospital. Case 25-2007. A 60-year-old man with fever, odynophagia, weight loss, and rash. N Engl J Med 2007; 357:692-701. [PMID: 17699820 DOI: 10.1056/nejmcpc079019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Abstract
Drug-induced photosensitivity involves reactions to medication triggered by exposure of the skin to ultraviolet light. Medications that trigger reactions can be topical or oral. Following interaction of ultraviolet radiation with a chemical present in sufficient amounts in the skin, one of the several reactions may occur in susceptible patients, most commonly photoallergy or phototoxicity. These reactions can be diagnosed separately based on pathogenesis, clinical characteristics and histopathology. Phototoxic disorders have a higher incidence than photoallergic disorders. The action spectra for most photoallergens and phototoxins lie in the ultraviolet A range. Subtypes of drug-induced photosensitivity include dyschromia, pseudoporphyria, photo onycholysis, and lichenoid and telangiectatic reactions.
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Affiliation(s)
- Kevin R Stein
- New York Medical College, Department of Dermatology, Metropolitan Hospital Center, New York, NY 10029, USA
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Scheuer E, Warshaw E. Sunscreen Allergy: A Review of Epidemiology, Clinical Characteristics, and Responsible Allergens. Dermatitis 2006; 17:3-11. [PMID: 16800271 DOI: 10.2310/6620.2006.05017] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Although allergy to sunscreen represents a small proportion (< 1%) of allergic contact dermatitis reactions in North America, it is one of the most common causes of photoallergy. The epidemiology and clinical characteristics of sunscreen allergy are summarized in this review. In addition, a detailed discussion of specific chemical sunscreen allergens is provided.
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Abstract
OBJECTIVE To better understand cutaneous photosensitivity reactions, a review of its etiologic factors, clinical characteristics, pathogenesis, and treatment modalities was undertaken. METHODS Articles discussing the above aspects of phototoxic and photoallergic reactions were used to demonstrate what is currently known about photoinduced reactions and how to treat them. RESULTS Upon interaction of solar UV radiation with the chemical that is present in significant levels on the skin, one of two known reactions may occur in susceptible patients: a phototoxicity and/or photoallergy. Phototoxic and photoallergic reactions can be diagnosed separately on the basis of pathogenesis, clinical characteristics, and histology. Examples of drugs capable of inducing a phototoxic reaction include amiodarone, retinoids, nonsteroidal antiinflammatory agents, diuretics, and antibiotics. Substances known to cause a photoallergic response are fragrances, sunscreens, topical antimicrobials, NSAID, and psychiatric medications, such as chlorpromezine. CONCLUSION Photoinduced reactions produced by exogenous chemicals are common skin disorders. Definitive therapy requires identifying and removing the offending agent, either the photosensitizing chemical or light. The use of fully protective clothing and a sunscreen of high SPF are important measures when light exposure is inevitable.
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Affiliation(s)
- Lela Lankerani
- Department of Dermatology, Case Western Reserve University, Cleveland, Ohio 44106, USA.
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Bastianon C, Zanoni R, Miolo G, Caffieri S, Reddi E. Mitochondria and plasma membrane as targets of UVA-induced toxicity of neuroleptic drugs fluphenazine, perphenazine and thioridazine. Int J Biochem Cell Biol 2005; 37:901-8. [PMID: 15694848 DOI: 10.1016/j.biocel.2004.11.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2004] [Revised: 09/30/2004] [Accepted: 11/09/2004] [Indexed: 11/21/2022]
Abstract
In order to gain insights into the mechanism of phototoxicity of the neuroleptic drugs fluphenazine, perphenazine and thioridazine in cultured cells, studies were performed with murine 3T3 fibroblasts, aimed at identifying some cellular targets responsible for photoinduced cell death and possible cytotoxic reactive species involved in the photosensitization process. 3T3 fibroblasts incubated with 5 microM drugs and irradiated with UVA light (up to 8 J/cm2) underwent cell death, the extent of which depended on light dose. Of the three drugs, fluphenazine exhibited the highest phototoxicity and 100% cell death was achieved with a light dose of 5 J/cm2. Superoxide dismutase and alpha-tocopherol exerted a dose-dependent protective effect against drug phototoxicity, whereas N-acetylcysteine failed to do so. These findings indicate that superoxide anion and other free radical intermediates, generated in lipophilic cellular environments, play a role in photoinduced toxicity. Phototreatment of drug-loaded cells induces release of the cytosolic enzyme lactate dehydrogenase and causes loss of activity of mitochondrial NADH dehydrogenase, indicating that plasma membrane and mitochondria are among the targets of the phototoxicity of these drugs.
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Affiliation(s)
- Chiara Bastianon
- Department of Biology, University of Padova, Viale G. Colombo 3, I-35121 Padova, Italy
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Abstract
Topical therapies can be used as a solo treatment or as an adjunct to the various surgical options to improve upon and maintain the desired anti-aging results. They may also be used as a preventative therapy in younger men and women. Few drugs are currently marketed for the treatment and prevention of skin aging, whereas many cosmeceuticals,the fastest growing segment of the skin-care market, and herbal remedies are touted in the lay press. More than ever, patients are looking for a magical elixir that is easy to use,effective, and inexpensive. The more commonly used products are covered in this article.
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Affiliation(s)
- Dee Anna Glaser
- Department of Dermatology, Saint Louis University, 1402 South Grand Blvd, St. Louis, MO 63104, USA.
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Abstract
We describe 5 patients whose histories and investigation findings point toward a diagnosis of photo-induced hand pompholyx, a previously unreported condition. Several factors have been associated with the exacerbation of pompholyx, but no direct relationship with sunlight exposure has been reported.
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Affiliation(s)
- Irene Man
- Photobiology Unit, Department of Dermatology, University of Dundee, Ninewells Hospital and Medical School, Scotland
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Ling TC, Gibbs NK, Rhodes LE. Treatment of polymorphic light eruption. PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE 2003; 19:217-27. [PMID: 14535892 DOI: 10.1034/j.1600-0781.2003.00048.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Polymorphic light eruption (PLE) is a highly prevalent photosensitivity disorder, estimated to affect 11-21% people in temperate countries. Typically, PLE appears as a recurrent pruritic eruption comprising papules and/or vesicles and/or plaques, which occurs on photo-exposed skin sites following sun exposure, and which heals without scarring. Commoner in females, the aetiology is uncertain, although there is evidence of an immune basis. We perform a review of the prophylaxis and treatment of this condition. While sun protection, corticosteroids and desensitization phototherapy are the mainstays of management, a range of anti-inflammatory and immunomodulatory agents are reported.
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Affiliation(s)
- Tsui C Ling
- Photobiology Unit, Dermatology Centre, University of Manchester, Hope Hospital, Manchester, UK
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Affiliation(s)
- Dee Anna Glaser
- Department of Dermatology, St. Louis University, 1402 S. Grand Boulevard, St. Louis, MO 63104, USA.
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Gilaberte Y, Coscojuela C, Sáenz de Santamaría MC, González S. Fotoprotección. ACTAS DERMO-SIFILIOGRAFICAS 2003. [DOI: 10.1016/s0001-7310(03)76688-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Miolo G, Caffieri S, Levorato L, Imbesi M, Giusti P, Uz T, Manev R, Manev H. Photoisomerization of fluvoxamine generates an isomer that has reduced activity on the 5-hydroxytryptamine transporter and does not affect cell proliferation. Eur J Pharmacol 2002; 450:223-9. [PMID: 12208313 DOI: 10.1016/s0014-2999(02)02156-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Fluvoxamine, a selective serotonin re-uptake inhibitor, is used as antidepressant/anxiolytic. The presence of a C=N double bond in the structure of fluvoxamine implies the existence of two geometric isomers: E- (trans) and Z- (cis), and suggests the hypothetical susceptibility of the molecule to photoisomerization. Clinically effective fluvoxamine is in its trans form. UVB (ultraviolet light, class B, wavelength range 290-320 nm) irradiation of aqueous solutions of fluvoxamine generated a photoproduct, which was isolated and analyzed by nuclear magnetic resonance (NMR) and mass spectrometry (MS), and identified as the cis isomer of fluvoxamine. This cis-isomer lost capacity to inhibit serotonin uptake, suggesting that light exposure might reduce the clinical efficacy of fluvoxamine. Alternatively, the photoproduct could be used as an inactive isomer in the studies of antidepressant mechanisms. Recent proposal suggests that antidepressants increase neurogenesis in the adult brain, whereas either an inhibitory or a stimulatory action of antidepressants on [(3)H]thymidine uptake in vitro has been attributed to their interaction with serotonergic mechanisms. Lower concentrations (i.e., 2 microM) of fluvoxamine and fluoxetine (another selective serotonin re-uptake inhibitor) stimulated [(3)H]thymidine uptake in mature, but inhibited it in immature cultures of rat cerebellar granule cells; the photoproduct was ineffective. A high concentration of fluvoxamine (i.e., 20 microM) but not the photoproduct was toxic to both immature and mature cultures. We suggest that a mechanism sensitive to fluvoxamine photoisomerization might be involved in the action of antidepressants on cell proliferation.
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Affiliation(s)
- Giorgia Miolo
- Department of Pharmaceutical Sciences, Padova University, 35131 Padua, Italy
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Affiliation(s)
- Allison L Naleway
- Epidemiology Research Center, Marshfield Medical Research and Education Foundation, 1000 North Oak Avenue, Marshfield, WI 54449, USA.
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Abstract
Promoting sunscreen use is an integral part of prevention programmes aimed at reducing ultraviolet (UV) radiation-induced skin damage and skin cancers. Protection against both UVB and UVA radiation is advocated. Most sunscreens combine chemical UV absorbing sunscreens and physical inorganic sunscreens, which reflect UV, to provide broad-spectrum protection. Newer triazole and camphor-derivative based sunscreens, also provide broad-spectrum protection and are more cosmetically acceptable than many traditional agents. Currently licensed sunscreen ingredients in common use rarely cause allergic or photoallergic reactions. Vitamin D levels are not significantly affected by regular use of a sunscreen. Sunscreen use reduces both the development of precancerous solar keratosis and the recurrence of squamous cell carcinomas. Sunscreen use early in life may be important in prevention of basal cell carcinomas. Increased melanoma risk is influenced by the behaviour patterns of regular sunscreen users, as opposed to any direct effect of sunscreens. Sun protection factor (SPF) is affected by application density, water resistance and other factors. An adequate SPF for an individual should be balanced to skin phenotype and exposure habits. The correct use of sunscreens should be combined with the avoidance of midday sun and the wearing of protective clothing and glasses, as part of an overall sun protection regimen.
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Abstract
We report a case of photoallergic contact dermatitis to two sunscreen agents, methoxycinnamate and oxybenzone, occurring in a 6-year-old Asian boy.
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Affiliation(s)
- Natasha Cook
- The Skin and Cancer Foundation, 177 Bourke Street, Darlinghurst, New South Wales 2010, Australia
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Casper KA, Mehta BH. Healthy skin for women: a review of common conditions and therapies. JOURNAL OF THE AMERICAN PHARMACEUTICAL ASSOCIATION (WASHINGTON, D.C. : 1996) 2002; 42:206-15; quiz 215-6. [PMID: 11926664 DOI: 10.1331/108658002763508506] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To review common dermatologic conditions that may be of particular concern to women throughout their lives, including acne, contact dermatitis, skin conditions of pregnancy, dry skin, and sun-related skin damage. DATA SOURCES Articles identified through a search of MEDLINE and pharmacology and dermatology textbooks using the terms women, dermatology, skin, acne, skin cancer, sunscreens, pregnancy, melanoma, basal cell carcinoma, dermatitis, cosmetic dermatitis, dry skin (xerosis), actinic keratosis, oral contraceptives, and striae. Additional references were identified from the bibliographies of retrieved articles and book chapters. DATA SYNTHESIS A number of skin conditions may be of particular concern to women throughout their lives. Acne, which may be particularly troublesome during the teenage years and young adulthood, and skin conditions that are common during pregnancy may be influenced by hormonal changes that occur at different life stages. Skin conditions that are influenced by the environment include contact dermatitis, dry skin, and sun-related skin damage, including actinic keratosis, carcinoma, and melanoma. Many of these conditions are amenable to nonpharmacologic therapy and over-the-counter treatments, whereas others require prescription pharmacotherapy. Pharmacists are in an ideal position to advise women about the appropriate management of these conditions and to identify lesions that require additional assessment. CONCLUSION Pharmacists can make valuable contributions to patients' self-care of the skin by recommending products, educating patients about skin health, and counseling patients about prescription medications. Gaining a greater understanding of skin conditions that are of particular concern to women can prepare pharmacists to make these contributions.
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Affiliation(s)
- Kristin A Casper
- College of Pharmacy, Ohio State University, Columbus 43210, USA.
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