Piroxicam is a new nonsteroidal anti-inflammatory drug(NSAID) and widely used in the management of rheumatoid arthritis and osteaorthritis. We experienced. two cases of photosensitive dermatitis developed while taking piroxicam. Both had pruritic and eczematous skin lesions on sun-exposed areas and showed positive reactions to 0. 1 % piroxicam solution in photopatch test in contrast with control group, which suggest a photoallergy mechanism. To our knowledge, these are the first reported cases in the Korean literature.
Arthritis, Rheumatoid ; Dermatitis ; Dermatitis, Photoallergic* ; Piroxicam ; Skin

Pigmented photoallergic contact dermatitis is a disease usually resulting from recurrent cutaneous exposure to cosmetic photoallergens which produce bizarre dark brown hyperpigmentation. Histologicnl examination of this condition reveals liquefaction of the basal cells of the epidmis and melanophages in the upper dermis. A 50-year-female developed dark brownish mottled hyperpigmented patches on her face after using a soap named O.E. and taking a nap every afternoon for 4 years. The histological fmding on the lesion site was consistent with pigmented photoallergic contact dermatitis. The cosmetic photopatch test with, O.E. soap, and the Scandinavian scries resulted in a positive reaction only on one side where 5 J/cm2 lights were applied by using Waldman 800UV machine. The other side howed a negative finding. We fmally diagnosed pigmented photoallergic contact dermatitis based on the patients histoty of using the soap containing musk ambrette, a histological examination of a biopsy and the results of photopatch tests. We report rare case of pigmented photoallergic contact dermatitis.
Biopsy ; Dermatitis, Photoallergic* ; Dermis ; Humans ; Hyperpigmentation ; Soaps

Introduction: Photocontact dermatitis is a type IV delayed hypersensitivity response to an allergen that is activated by radiation energy. Its incidence is uncertain and only a small number of drugs causing such reaction have been studied. This is a case of a 67-year-old filipino male, diabetic, who presented with scaly, erythematous, and hyperpigmented plaques with areas of desquamation and erosions on sunexposed areas of the skin after taking metformin. Case: Four months prior to consult, the patient was diagnosed with type 2 diabetes mellitus and was started on metformin therapy. Days later, he started noticing scaly, erythematous and hyperpigmented plaques with areas of desquamation and erosions on sun-exposed areas, namely the upper and lower extremities, posterior neck, and forehead. There was notable sparing of areas that are usually covered with clothing such as the torso, inguina and both thighs. There were also no lesions on the scalp, palmar aspect of the hands and plantar surface of the feet. Skin biopsy was considered but was not done per patient’s preference. After discontinuation of metformin and avoidance from sun exposure, the skin lesions gradually improved. Conclusion Metformin is rarely associated with adverse skin reactions. The diagnosis of photocontact dermatitis as a side effect of metformin needs to be considered as a differential diagnosis in patients who present with skin rashes, especially in sun-exposed areas. It is recommended that there should be a high-index of suspicion for adverse drug reactions in such patients. This would reduce medical errors and medical cost and would result to prompt initiation of appropriate treatment.
Metformin ; Dermatitis, Photoallergic ; Diabetes Mellitus, Type 2

Benzophenones are aromatic ketone derivatives of dibenzoylmethane, exhibiting absorption characteristics not only in the UVC and UVB spectral ranges but also in part of the UVA range, up to 360nm. They are commonly used for extending the spectrum of photoprotection. Benzophenone-3, one of the most popular benzophenones, is the most common cause of sunscreen allergy as well as a substitute of PABA. We report a case of photoallergic contact dermatitis due to benzophenone-3 of sunscreen.
4-Aminobenzoic Acid ; Absorption ; Benzophenones ; Dermatitis, Photoallergic* ; Hypersensitivity

One adverse effect of PUVA therapy is the development of severe dermatitis. Only a few cases of photoallergy to psoralens during PUVA therapy have been reported. We describe herein a patient with photoallergic dermatitis induced by PUVA with 8-methoxypsoralen(8-MOP). A 38-year old woman with generalized vitiligo had acute pruritic exanthematous maculopapular lesions in the treated areas after PUVA therapy with 8-MOP. A patch test and photopatch test were performed with 8-MOP, 5-MOP, and 4,5,8-trimethylpsoralen(TMP). The patch test carried out with these psoralen derivatives were all negative, but the photopatch test showed a positive reaction to 8-MOP. The patient consequently had PUVA therapy with 5-MOP and she had no further experience of a photoallergic reaction.
Dermatitis ; Dermatitis, Photoallergic* ; Female ; Ficusin ; Furocoumarins ; Humans ; Methoxsalen* ; Patch Tests ; PUVA Therapy ; Vitiligo

Ketoprofen is an nonsteroidal anti-inflammatory drug derived from propionic acid. It has been widely used as topical preparations, as gel or patch. It has been reported that topical ketoprofen can cause contact dermatitis and photocontact dermatitis. We experienced five cases of contact dermatitis, developed after applying ketoprofen patch(Ketotop(R), Pacific pharmaceutical Co., Korea) for the control of oste omuscular or joint pain. While one patient had generalized urticarial eruption, the rest of patents showed localized erythematous pruritic eczematous skin eruptions. It was verified through intradermal skin test and pin prick test that ketoprofen itself was not the causative drug for the skin eruption. Patch test excluded the possibility of allergic skin reaction to rubber compounds. It should be elucidated which compounds are allergic or toxic to the skin, contained in woven fabrics.
Arthralgia ; Dermatitis, Contact* ; Dermatitis, Photoallergic ; Diethylpropion ; Humans ; Ketoprofen* ; Patch Tests ; Rubber ; Skin ; Skin Tests

BACKGROUND: Although dermatologists may encounter photosensitivity patients commonly, most dermatologists are not familiar with diseases manifesting photosensitivity and there is still no clinical study on photosensitivity disease in Korea. OBJECTIVE: We tried to investigate incidences and sorts of photosensitivity diseases with clinical informations. METHODS: We performed a retrospective clinical review of patients who had photosensitivity as a chief complaint in the department of dermatology, Gyeongsang National University hospital from 1991 to 2000. RESULTS: There were a variety of diverse photosensitive diseases in this clinical study. Drug-induced photosensitivity including phototoxicity and photoallergy were fairly common (19.7%), and causative drugs were various including antibiotics, diuretics and even medicinal herb. We could find co-occurrence of some diseases in photosensitivity patients (39.3%), most of which were chronic degenerative diseases. CONCLUSION: Further clinical studies will be needed to get additional and standardized information in Korea, and precise clinical work-ups would be necessary to differentiate variable spectrums of photosensitivity diseases we showed in this study.
Anti-Bacterial Agents ; Dermatitis, Photoallergic ; Dermatitis, Phototoxic ; Dermatology ; Diuretics ; Humans ; Incidence ; Korea ; Plants, Medicinal ; Retrospective Studies

Fluorescein has been used for decades in ophthalmology for fluorescence angiography and it is the only fluorophore routinely used in experimental dermatology for in vivo study of the skin. It absorbs blue light, with peak absorption and excitation wavelengths between 465 and 490 nm and fluoresces at yellow-green wavelengths of 520~530 nm. The most common side effects are nausea and vomiting, and other adverse events such as a vasovagal response, cardiac or respiratory effects, neurologic manifestations or allergy, including anaphylaxis, were also reported. But a photosensitive reaction to fluorescein is very rare. We report here on a case of photoallergic dermatitis due to fluorescein after fluorescence angiography.
Absorption ; Anaphylaxis ; Dermatitis, Photoallergic ; Dermatology ; Fluorescein ; Fluorescein Angiography ; Hypersensitivity ; Light ; Nausea ; Neurologic Manifestations ; Ophthalmology ; Skin ; Vomiting

It is believed that the photopatch test is a valuable screening procedure for the determination of responsible antigenic substances in photoallergic contact dermatitis. But the technigues used for this procedure are cumbersome and require expensive equipment. In the present study, we adapted an easy and inexpensive photopatch test met- hod to our need. We report the results of this test method which was performed. in 21 patients with photodermatitis and 9 patients with polymorphic light eruption. 1. The UVB sensitivity determined by minimal erytherna dose (mean+-standard deviation) was I1618mW sec/cm in photodermatitis group, 108+ROmW sec/cm in polymorphic light eruption group and 126-+32mW-sec/cm in control group. But there was no significant difference among them (p>0. 05). 2. The reaction to UVA were negative in all groups. R. The photopatch test using IO potential photosensitizers revealed 12 positive responses in 9 patients; including 7 patients in photodermatitis group and 2 patients in polymorphic light eruption group. And the number of positive photopatch responses obtaied with each photosensitizer in RO patients with photodermatoses was 5 in chlorhexidine, 2 in paraaminobenzoic acid, musk ambrette and bithionol and 1 in chlorpromazine, respectively.
Bithionol ; Chlorhexidine ; Chlorpromazine ; Dermatitis, Photoallergic ; Humans ; Mass Screening ; Photosensitivity Disorders ; Photosensitizing Agents

BACKGROUND: Antihistamine drugs are used widely in many conditions. Although some antihistamines may cause a photosensitive reaction,many physicians are not awae of it. OBJECTIVE: For examination of the phototoxic potential of antihistamines, we performed the Candida albiecrns test which is simple, cheap, and good for the screening of many drugs. MEHTODS: Thirty microliters of each solute of various antihistamines were applied to the Sabraud dextrose agar plate in which Candida albicans were applied diffusly. Four hours after the application, 60J/cm fo UVA was irradiated for two days. The irradiated. plates and nonirradiated control ones were incubated in a dark room for 48 hours, and examined for lear zones arround the drug, which means a positive results for the phototoxic potential of the drugs. RESULTS: Mequitazine, thiethylperazine, perphenazine and cllorromazine showed positive results, whereas others did not. An additional Candida albicans test using 0.1%, 0.01%, and 0.001% of the positive drugs revealed tht chlorpromazine, thiethylperazine aderphenazine showed positive results at 0.1%, but negative at 0.01 and 0.001%. Mequitazine was niegative at 0.1, 0.01, and 0,001%, Additional studies of the Candida albicans test using 5% and 10% of the diphenhydramine and dimenhydrinate, those were known photosensitizers but they slowed negative results at this study and revealed very weak posit,ive result in 10% diphenhydramine. CONCLUSION: A photosensitive reaction such as photoallergy and persistent light react,ion may be triggered by the phenothiazine antihistamines. Negative result in 1%, and very weak positive results in 10% diphenhydramine may be due to different mechanism of phototoxicity, or the low phototoxic potential of diphenhydrainine.
Agar ; Candida albicans* ; Candida* ; Chlorpromazine ; Dermatitis, Photoallergic ; Dermatitis, Phototoxic* ; Dimenhydrinate ; Diphenhydramine ; Glucose ; Histamine Antagonists ; Mass Screening* ; Perphenazine ; Photosensitizing Agents ; Thiethylperazine