Amiodarone photosensitivity

Abstract

Amiodarone hydrochloride is currently being investigated in the United States as a cardiac antiarrhythmic agent. Previous reports from Europe indicate that amiodarone occasionally causes a cutaneous photosensitivity reaction that may be associated with a peculiar blue-gray discoloration of the skin. In addition, corneal microdeposits of yellow-brown granules may occur. We report observations on a case of amiodarone photosensitivity and corneal deposits developing in a patient shortly after amiodarone therapy was begun. Symptoms included burning and stinging of the skin, with redness and swelling that developed immediately after sun exposure. Phototesting showed that the photoactivating wavelengths were primarily in the long-wave UV-A spectrum between 350 and 380 nm. Prior application of a 10% dioxybenzone sunscreen greatly reduced the phototest reaction. Four weeks after the patient stopped taking amiodarone, the UV-A sensitivity was still present but diminished, and by ten weeks it had disappeared. During this time, the corneal deposits were reduced in number. All ten patients we have treated so far with amiodarone for cardiac arrhythmias have shown a similar photosensitivity, indicating that this is probably a phototoxic reaction.

A study of cutaneous photosensitivity induced by amiodarone

“…The administration of amiodarone is accompanied by a relatively large number of cutaneous side-effects. The incidence of photosensitivity in this study was 50%, a figure closely in agreement with previous reports in the United Kingdom (Chalmers et ah, 1982) and in the United States of America (Walter, Bradner & Curtis, 1984). This high level of cutaneous involvement is strongly suggestive of a phototoxic reaction, as was the clinical presentation of burning erythema without any accompanying dermatitis.…”

Photodistribution of Blue-Gray Hyperpigmentation After Amiodarone Treatment

“…7 The photoactivating wavelengths are primarily found in the long-wave UV-A spectrum between 350 and 380 nm. 8 However, phototests may show acute reactions to UV-A and UV-B and significant delayed reactions to UV-A and/or UV-B. 4,9 Zinc oxide-containing preparations appear to be the most effective agents for reducing cutaneous photosensitivity.…”

Bronchial Pigmentation as a Manifestation of Amiodarone Pulmonary Toxicity

“…6 It was demonstrated that these granules are found in skin and corneal deposits, and activated by sun exposure. 7 The reported incidence of amiodarone phototoxicity is noted to be 10% in patients on unprotected sun exposed areas. 8 Autopsy studies have demonstrated higher concentrations of amiodarone and desethyl-amiodarone in pigmented than in unpigmented skin.…”