Abstract
Photoallergic reactions are Type IV hypersensitivity reactions localized to photo-exposed areas, with generalization in severe cases. Diagnosis is based on history, photo-patch testing and clinico-histopathological correlation. A 47-year-old man developed multiple, erythematous plaques over V-area of neck, retroauricular area, extensor aspect of both forearms after oral cefixime post-cholecystectomy. He had similar episode of lesser severity two months ago after oral Cefixime. Histopathology showed acanthotic epidermis, foci of spongiosis causing vesiculation with lymphocytes. Upper dermis showed infiltrate of lymphocytes and neutrophils along with perivascular infiltrate. Diagnosis was photoallergic reaction to Cefixime. Lesions completely subsided with oral steroids, hydroxychloroquine, antihistamines, sunscreen and emollients over two months. Cephalosporins have multiple side-effects including hypersensitivity, rash, Steven–Johnson syndrome and toxic epidermal necrolysis. Cephalosporin induced photoallergy is not reported. Hence, cephalosporins should be added to the existing list of systemic drugs causing photoallergic reactions.
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