Sparfloxacin-induced photosensitivity and the occurrence of a lichenoid tissue reaction after prolonged exposure

• Published in: Journal of the American Academy of Dermatology 1998-06, Vol.38 (6), p.945-949
• Main Authors: Hamanaka, Hiroko, Mizutani, Hitoshi, Shimizu, Masayuki
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Anti-Infective Agents - adverse effects; Biological and medical sciences; Drug Eruptions - etiology; Drug Eruptions - metabolism; Drug Eruptions - pathology; Drug toxicity and drugs side effects treatment; Female; Fluoroquinolones; HLA-DR Antigens - analysis; Humans; Immunohistochemistry; Intercellular Adhesion Molecule-1 - analysis; Lichenoid Eruptions - chemically induced; Lichenoid Eruptions - metabolism; Lichenoid Eruptions - pathology; Male; Medical sciences; Middle Aged; Pharmacology. Drug treatments; Photosensitivity Disorders - chemically induced; Photosensitivity Disorders - metabolism; Photosensitivity Disorders - pathology; Quinolones - adverse effects; Skin - metabolism; Skin - pathology; Toxicity: skin, dermoskeleton
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/S0190-9622(98)70157-4

Background: A new antibacterial quinolone, sparfloxacin (SPFX), frequently causes photosensitive dermatitis and sometimes induces a treatment-resistant lichenoid tissue reaction (LTR). Objective: We attempted to determine the factors that induce LTR in SPFX-induced photodermatitis. Methods: Thirteen patients with SPFX photosensitive dermatitis were studied clinically and histopathologically. Results: Six of the 13 patients had acute dermatitis with epidermal spongiosis and focal epidermal HLA-DR and intercellular adhesion molecule–1 (ICAM-1) expression with CD4 + cell infiltration. The other seven displayed LTR with basal cell liquefaction degeneration and diffuse epidermal HLA-DR and ICAM-1 expression associated with CD8 + cells. The seven patients with LTR were exposed to UV and SPFX for more than 2 weeks after the appearance of their initial eruption, whereas the six patients with acute dermatitis were treated within 2 weeks. The acute dermatitis lesions cleared significantly within 2 weeks, but the LTR lesions persisted for more than 6 weeks. Conclusion: Patients with quinolone-induced photosensitivity should be treated within 2 weeks of onset to prevent LTR. (J Am Acad Dermatol 1998;38:945-9.)