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Review
. 2021 Jul 26;14(8):723.
doi: 10.3390/ph14080723.

Drug-Induced Photosensitivity-From Light and Chemistry to Biological Reactions and Clinical Symptoms

Justyna Kowalska  1 , Jakub Rok  1 , Zuzanna Rzepka  1 , Dorota Wrześniok  1
Affiliations
Review

Drug-Induced Photosensitivity-From Light and Chemistry to Biological Reactions and Clinical Symptoms

Justyna Kowalska et al. Pharmaceuticals (Basel). .

Abstract

Photosensitivity is one of the most common cutaneous adverse drug reactions. There are two types of drug-induced photosensitivity: photoallergy and phototoxicity. Currently, the number of photosensitization cases is constantly increasing due to excessive exposure to sunlight, the aesthetic value of a tan, and the increasing number of photosensitizing substances in food, dietary supplements, and pharmaceutical and cosmetic products. The risk of photosensitivity reactions relates to several hundred externally and systemically administered drugs, including nonsteroidal anti-inflammatory, cardiovascular, psychotropic, antimicrobial, antihyperlipidemic, and antineoplastic drugs. Photosensitivity reactions often lead to hospitalization, additional treatment, medical management, decrease in patient's comfort, and the limitations of drug usage. Mechanisms of drug-induced photosensitivity are complex and are observed at a cellular, molecular, and biochemical level. Photoexcitation and photoconversion of drugs trigger multidirectional biological reactions, including oxidative stress, inflammation, and changes in melanin synthesis. These effects contribute to the appearance of the following symptoms: erythema, swelling, blisters, exudation, peeling, burning, itching, and hyperpigmentation of the skin. This article reviews in detail the chemical and biological basis of drug-induced photosensitivity. The following factors are considered: the chemical properties, the influence of individual ranges of sunlight, the presence of melanin biopolymers, and the defense mechanisms of particular types of tested cells.

Keywords: melanin; oxidative stress; photoallergy; photodegradation; phototoxicity.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Mechanism of ketoprofen photodecarboxylation process.
Figure 2
Figure 2
Synthesis of ketoprofenyl-acylglycerols.
Figure 3
Figure 3
The photodegradation process of nifedipine.
Figure 4
Figure 4
The photodegradation process of amiodarone.
Figure 5
Figure 5
The photodecarboxylation process of fenofibrate.
Figure 6
Figure 6
Generation of sulfur-centered peroxy radical in photolysis of phenothiazines.
Figure 7
Figure 7
The photodecarboxylation process of voriconazole metabolite.
Figure 8
Figure 8
The photolysis of 8-halogenated fluoroquinolones.
Figure 9
Figure 9
The photolysis of tetracyclines.
Figure 10
Figure 10
The photodegradation process of vandetanib.
Figure 11
Figure 11
Mechanisms of drug-induced photosensitivity (Ph—phototoxic drug; ROS—reactive oxygen species).
See this image and copyright information in PMC

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