Bullous photodermatosis after lomefloxacin

Detection of specific IgE to quinolones

“…Indeed, various authors have claimed cross-reactivity between quinolones on the basis of clinical data. 6,9,[33][34][35][36][37][38] Our data support this notion because several patients reported a reaction with more than one quinolone (9/55 [16%]). Moreover, the majority of our patients revealed IgE toward more than one quinolone (24/30 [80%]).…”

Photosensitivity to lomefloxacin. A clinical and photobiological study

“…Our patients illustrate the polymorphism of clinical photosensitivity to systemic drugs, which was already apparent in previous cases with quinolones: bullous sunburn in a 25-year-old woman, occurring after an intense sun exposure in the snow (17), or erythematous and oedematous lesions with vesicles and/or bullae appearing a few days after beginning of treatment, mainly in old patients (15,16). This is certainly dependent on the complex mechanisms of photosensitivity, with acute phototoxic situations resembling acute sunburn reactions, even with bullae, as in the case described by Poh-Fitzpatrick (17) and in our patients 2, 5, 7 and 8; more eczematous lesions in cases where photallergy is suspected as in cases reported by Kurumaji and Shono (15) and Correia et al (16) and in our case 1.…”

“…Pathology performed in 4 of our patients clearly supports a phototoxic reaction with sunburn-like keratinocytes. In the case reported by Correia et al (16), however, histopathology and the study of the inflammatory cells of the liquid of the bullae (revealing a high percentage of Thelper lymphocytes) favours an immunologic reaction, with positive photopatch tests, with a cross-reaction with ciprofloxacin supporting photoallergy (16). Kurumaji and Shono had to perform a prior scarification in order to obtain positive reactions to this high molecular weight drug (15), which was not necessary in our case 1.…”

Photosensitivity induced by lomefloxacin with cross‐photosensitivity to ciprofloxacin and fleroxacin

“…Certain new 4-quinolones, especially enoxacin (ENX) with a naphthyridine ring and SPFX and LFLX with a quinolone ring, are well-known to cause photosensitivity (4)(5)(6)(7)(8). Photosensitivity induced by LFLX is thought to be due to both phototoxic and photoallergic mechanisms (4,9), photopatch testing with LFLX commonly being negative (10) Cross-photosensitivity to other quinolones has hardly ever been reported (5). An animal study indicated that LFLX had the highest phototoxic potential of the 4-quinolones, also caused photoallergy, and showed no cross-photosensitivity with other 4quinolones (11).…”