Photosensitivity Due to Chlorpropamide

Hitselberger, James F.; Fosnaugh, Robert P.

doi:10.1001/jama.1962.03050140064017a

Cited by 32 publications

(6 citation statements)

References 6 publications

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“…1) we did, however, find a moderate lowering of the MED to 25% of its former value 3 h after the ingestion of a small amount of chlorpropamide. These observations are in agreement with those of H itselbf.rger and F osnaug h [11]. Administration of the drug, however, does involve an element of risk, and the use of more sophisticated tests, such as the basophil degranulation test, the lymphocytic transformation test or a suitable modification of either, might provide a better solution to this problem.…”

Section: Discussionsupporting

confidence: 88%

“…Such a conclusion has also been reached by H itselberger and Fosnaugh [11], It should be noted that two of our patients (No. 4 and 5) had past histories of unusual and even rare diseases (table 1).…”

Section: Discussionsupporting

confidence: 87%

“…[9] state that the activation wavelength of chlor propamide is 290 nm and its fluorescence wavelength 340 nm, but their review does not give any account of clinical instances of photosensitivity induced by chlorpropamide. Hitselberger and Fosnaugh [11] reported such a case, and it is the only one described in detail, as far as we know.It is the purpose of this paper to describe five cases of chlorpropamideinduced photosensitivity which were treated in our ward during the years 1968-1970. …”

mentioning

confidence: 80%

“…Most cases are of the exanthematic erythematous type [15], but rashes with the morphology of urticaria [I, 4], erythema exudativum multiforme [16,17], purpura [10] and lichen planus mucosae oris [5] have been reported. Hitsel-Feukrman/F rumkin berger and F o sn a u g h [11] have reported a case of photosensitivity with cross-reaction to tolbutamide. We think that the incidence of chlorpropamideinduced photosensitivity is probably much higher than might be suspected from the rarity of reports.…”

Section: Discussionmentioning

confidence: 99%

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Photodermatitis Induced by Chlorpropamide

Feuerman¹,

Frumkin²

1973

Dermatology

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Five diabetic patients developed photodermatitis following the ingestion of 250–500 mg chlorpropamide per day, from 3 weeks to 4 years after the onset of therapy. Four patients developed the rash in August and September and one in December. Four patients were treated successfully by withdrawing chlorpropamide, shielding from sunlight and administering local symptomatic therapy, while the fifth patient had to be given corticosteroids. In four patients, the skin ultimately cleared, but one patient developed a residual leukomelanoderma. In one patient the minimal erythema dose was found to be lowered a few hours after ingesting a small dose of chlorpropamide.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionsupporting

confidence: 87%

mentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

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Photodermatitis Induced by Chlorpropamide

Feuerman¹,

Frumkin²

1973

Dermatology

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“…Purely dermatological toxicity often shows itself as an erythematous rash of varying severity which disappears on withdrawal of the drug. Photosensitivity (Hitselberger and Fosnaugh, 1962), erythema nodosum, erythema multiforme (Stewart et al, 1959), and the Stevens-Johnson syndrome (Yaffee, 1960) have occurred, but hitherto no fatal reaction has been reported in the literature. These skin manifestations are paralleled closely by those due to the sulphonamides, and the fatal effects of some long-acting preparations have recently been reviewed in these columns (B.M.7., 1964).…”

Section: Fatal Case Of Toxic Erythema Aftermentioning

confidence: 99%

Fatal case of toxic erythema after chlorpropamide (Diabinese).

Tullett¹

1966

BMJ

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Chlorpropamide is widely used for the control of late onset nonketotic diabetes mellitus, and is classed as an arylsulphonylurea. Among its many side-effects are blood dyscrasias, which include thrombocytopenia (Fitzpatrick, 1963), leucopenia, low-grade anaemia, eosinophilia (Rothfeld et al., 1960), aplastic anaemia (Erslev, 1964), and agranulocytosis (Stein, 1964). Transient gastrointestinal disturbances, intolerance of alcohol, hypoglycaemia (sometimes prolonged), impairment of liver function (Rothfeld et al., 1960), foetal damage (Campbell, 1963), and neuropathy have been reported.Purely dermatological toxicity often shows itself as an erythematous rash of varying severity which disappears on withdrawal of the drug. Photosensitivity (Hitselberger and Fosnaugh, 1962), erythema nodosum, erythema multiforme (Stewart et al., 1959), and the Stevens-Johnson syndrome (Yaffee, 1960) have occurred, but hitherto no fatal reaction has been reported in the literature. These skin manifestations are paralleled closely by those due to the sulphonamides, and the fatal effects of some long-acting preparations have recently been reviewed in these columns (B.M.7., 1964). CASE REPORTA lady of 71 consulted her doctor about a scaly rash on her knees and excessive thirst. Psoriasis and diabetes mellitus were diagnosed and Diabinese (chlorpropamide) prescribed, 250 mg. twice daily being given for three days, then increased to 500 mg. twice daily for two days, and-lowered to 250 mg. twice daily as glycosuria was controlled. A few days later she developed an extensive purplish skin eruption, while mouth lesions rendered swallowing painful.The drug was withdrawn on the third day of this reaction and antihistamine given.She was admitted to hospital on the tenth day of the rash, and examination showed perhaps 85% of the skin involved by purpuric lesions, some of which could be recognized as target-like. Marked crusting was present on her face and lips, there was severe conjunctivitis and chemosis, and the oral mucosae were denuded. Large intact bullae were present on the feet and ankles. Her blood-pressure was 150/70 mm. Hg, and no abnormality was found in the heart, lungs, or abdomen. Though a diagnosis of severe drug eruption was made at this time, her general condition gave no cause for alarm. Plasma electrolytes, alkali reserve, and urea were normal, while the blood sugar was 296 mg./100 ml. A radiograph of the chest showed slight cardiac enlargement, a clean sample of urine revealed 20 leucocytes per high-power field, and culture yielded a moderate growth of Staph. pyogenes. Her white cell count was 5,000, and E.S.R. was 27 mm./hour.However, after a further 48 hours her condition deteriorated, the eruption had become more extensive, and a staphylococcus was isolated from the mouth and conjunctivae which was sensitive to a wide range of antibiotics, though untypable by phages. Her blood sugar rose to 520 mg./100 ml. and urine became strongly positive for ketones. Treatment with soluble insulin controlled this moderate ketosis, but sh...

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Photoallergy

Epstein¹

1972

Arch Dermatol

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Photosensitivity Due to Chlorpropamide

Cited by 32 publications

References 6 publications

Photodermatitis Induced by Chlorpropamide

Photodermatitis Induced by Chlorpropamide

Fatal case of toxic erythema after chlorpropamide (Diabinese).

Photoallergy

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