Drug‐induced photosensitivity: culprit drugs, potential mechanisms and clinical consequences

Abstract

Summary Drug‐induced photosensitivity, the development of phototoxic or photoallergic reactions due to pharmaceuticals and subsequent exposure to ultraviolet or visible light, is an adverse effect of growing interest. This is illustrated by the broad spectrum of recent investigations on the topic, ranging from molecular mechanisms and culprit drugs through epidemiological as well as public health related issues to long‐term photoaging and potential photocarcinogenic consequences. The present review summarizes the current state of knowledge on the topic while focusing on culprit drugs and long‐term effects. In total, 393 different drugs or drug compounds are reported to have a photosensitizing potential, although the level of evidence regarding their ability to induce photosensitive reactions varies markedly among these agents. The pharmaceuticals of interest belong to a wide variety of drug classes. The epidemiological risk associated with the use of photosensitizers is difficult to assess due to under‐reporting and geographical differences. However, the widespread use of photosensitizing drugs combined with the potential photocarcinogenic effects reported for several agents has major implications for health and safety and suggests a need for further research on the long‐term effects.

Photochemistry of Common Xanthene Fluorescent Dyes as Efficient Visible-light Activatable CO-Releasing Molecules

“…The potential phototoxicity of chemicals used in human medicine is much less explored. 44 Mechanisms of phototoxicity involve, for example, photosensitization 45 or degradation to a toxic product. 46 Photochemically induced adverse effects of drugs are often unreported or misdiagnosed.…”

Statistical Methods to Support Difficult Diagnoses

“…However, these drugs are known to enhance photosensitivity. In combination with usually well-tolerated sunlight, these drugs can create severe sunburn such as skin reactions (see [ 9 , 10 ]).…”

Anticancer treatments and photosensitivity

“… * Common causative agents were identified as drugs with a high level of evidence of their photosensitizing effects (i.e. number of publications n ≥ 15) according to Hofmann and Weber (2021), 4 and classed as causing phototoxicity and/or photoallergy according to Gould et al . (1995), 1 and Monteiro et al .…”

“…1,2 Drug-induced photosensitivity can occur when components of topical or systemic agents present in the skin act as exogenous chromophores and are activated by a component of the electromagnetic spectrum of sunlight, most commonly ultraviolet A (UVA) radiation (320-400 nm). 1,3,4 Photosensitivity: Phototoxicity and photoallergy Drug-induced photosensitivity can be classified as either phototoxic or photoallergic reactions based on the underlying pathophysiological mechanism, although differences in the time to onset, clinical presentation, and incidence of these reactions have also been reported (Table 1). 1,3,4 Phototoxic drug reactions are the most frequent type of druginduced photosensitivity and can occur in any patient following exposure to a photosensitizing agent and UV radiation.…”