Severe Photosensitivity Reaction After Pirfenidone Use

Choudhury, Saiara; Taweesedt, Pahnwat; Dadhwal, Rahul; Surani, Salim

doi:10.7759/cureus.16626

Cited by 2 publications

(1 citation statement)

References 8 publications

(16 reference statements)

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“…Of these patients, 13 patients were given local glucocorticoid therapy, and 10 patients were given systemic glucocorticoid therapy. Four patients switched to other drugs, such as acetylcysteine, nintedanib, cyclosporine and hydroxychloroquine 16,19,22,29 . In addition, 2 patients were given antihistamines, 12,14 and other local treatments, including silver sulfadiazine and pimecrolimus, were administered to one patient 21,24 .…”

Section: Resultsmentioning

confidence: 99%

Retrospective analysis of skin photosensitivity induced by pirfenidone

Wang

Sun

et al. 2021

Clinical Pharmacy Therapeu

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What is known and objective Knowledge regarding the association between photosensitivity and pirfenidone is based mainly on case reports. The purpose of this article was to evaluate the clinical characteristics of photosensitivity associated with pirfenidone. Methods We collected studies on photosensitivity induced by pirfenidone published from 2008 to 31 August 2021 in Chinese and English for a retrospective analysis. Results and discussion The median age was 70 years (range 57–80) in 22 patients with pirfenidone‐induced photosensitivity. The dose at the onset of symptoms ranged from 600 to 2403 mg for the treatment of idiopathic pulmonary fibrosis. Pirfenidone‐induced photosensitivity occurred within 1 week in some patients and up to 8 months in others. The most common clinical manifestation of photosensitivity caused by pirfenidone was itching on body parts exposed to sunlight (back of hands, face, neck, and limbs) in 15 patients followed by erythema in 13 patients. Histopathological examination revealed necrotic keratinocytes, lymphocytic inflammatory cell infiltrate, hyperkeratosis and liquefaction degeneration in 5 patients. The photosensitivity test showed a markedly decreased minimum erythema dose (MED) of 7–228 mJ/cm2 UV‐B in 4 patients and 4.86–12 J/cm2 UV‐A in 5 patients. The clinical symptoms were significantly improved or completely relieved with a median time of 4 weeks (range 1–8) after drug withdrawal, dose reduction or systemic and topical glucocorticoid therapy. What is new and conclusion Clinicians should be aware of the potential phototoxic effects of pirfenidone and should inform patients to take pirfenidone during (or after) a meal, avoid sun exposure, wear protective clothing, and apply broad‐spectrum sunscreen with high ultraviolet UVA and UVB protection.

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Section: Resultsmentioning

confidence: 99%