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.
Highlights
This interaction leads to the formation of reactive oxygen species (ROS), such as superoxide anion, hydrogen peroxide, and hydroxyl radical, which are responsible for oxidation damage of the cell
Our preliminary study of minocycline revealed that the drug significantly increased melanin content and the activity of tyrosinase—the key enzyme of melanogenesis
Photosensitivity is a side effect of the following classes of cardiovascular drugs: (a) diuretics: hydrochlorothiazide, chlorthalidone, indapamide, bumetanide, furosemide; angiotensin-converting enzyme (ACE) inhibitors: ramipril, quinapril, enalapril; angiotensin receptor blockers (ARBs): valsartan; calcium channel blockers: amlodipine, nifedipine, diltiazem; beta-blockers: tilisolol; antiarrhythmic drugs: amiodarone; antithrombotic agents: clopidogrel, triflusal; others: rilmenidine, methyldopa
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Cutaneous adverse drug reactions are thought to be one of the most frequently occurring ADRs [3,4]. They often require hospitalization, additional treatment, medical management, and generate significant costs for the payer as well as for the service provider [5,6,7]. Symptoms of drug-induced photosensitivity usually appear up to several hours after exposure to sunlight and include erythema, swelling, blisters, exudation, peeling, burning, itching, and hyperpigmentation of the skin. These changes are observed directly in places exposed to solar radiation [10]
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