Possible phototoxicity with subsequent progression to discoid lupus following pantoprazole administration

Lansoprazole-induced subacute cutaneous lupus erythematosus

“…The mean onset of cutaneous features has been reported as 7.27 weeks (range 4-20) after initiation of the drug, and most symptoms improve within 6-12 weeks of discontinuation. 5 Our case is interesting because of the paucity of previous reports and the recurrence of the eruption on inadvertent re-administration of lansoprazole on admission to hospital, which confirmed the drug as the likely inducer of SCLE. 2 The autoantibody profile may remain positive despite discontinuation of the drug.…”

Letter to the Editor Subacute cutaneous lupus erythematosus due to proton pump inhibitor intake: and literature review

“…The PPIs induce a pronounced and long-lasting reduction of gastric acid production, being the most potent inhibitors of acid secretion available today. In general, PPIs are well tolerated, although some recent reports have raised concerns about the possibility of LE induction due to intake of PPIs [1–6]. …”

“…The history of the first reported patient with PPI-induced (pantoprazole) LE differs significantly from the other described subjects, as initially (8 days after initiation of pantoprazole) phototoxic lesions were noted that cleared over a period of one month upon discontinuation of pantoprazole, but after another thirteen months discoid lupus erythematosus developed in the areas of the most intense phototoxic lesions [1]. Remarkably, the patient was proven to be anti-Ro positive at the time of phototoxic reaction [1].…”

“…Upon discontinuation of PPIs a rapid complete remission was usually noted (Table I). Only in patient 1 with discoid lesions did some residual skin symptoms remain [1]. …”

In Vitro Evaluation of Phototoxic Properties of Proton Pump Inhibitors, H2-receptor Antagonists and Statins

“…However, there are some case reports of photosensitive side-effects (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12): ranitidine has been shown to induce increased photosensitivity, whereas pantoprazole, lansoprazole and omeprazole have been associated with the development of cutaneous lupus erythematosus, a known photosensitive skin disease. Another group of frequently prescribed drugs, statins are used to significantly decrease the serum levels of cholesterol, thus stabilizing atherosclerotic plaques.…”