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Drug-induced Photosensitivity

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181. Systemic Lupus Erythematosus (Overview)

in women, frequently starting at childbearing age. See the image below. Photosensitive systemic lupus erythematosus (SLE) rashes typically occur on the face or extremities, which are sun-exposed regions. Although the interphalangeal spaces are affected, the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints are spared. Photo courtesy of Dr. Erik Stratman, Marshfield Clinic. See , a Critical Images slideshow, to help recognize cutaneous manifestations (...) [ ] : Constitutional (eg, fatigue, fever, arthralgia, weight changes) Musculoskeletal (eg, arthralgia, arthropathy, myalgia, frank arthritis, avascular necrosis) Dermatologic (eg, malar rash, photosensitivity, discoid lupus) Renal (eg, acute or chronic renal failure, acute nephritic disease) Neuropsychiatric (eg, seizure, psychosis) Pulmonary (eg, pleurisy, pleural effusion, pneumonitis, pulmonary hypertension, interstitial lung disease) Gastrointestinal (eg, nausea, dyspepsia, abdominal pain) Cardiac (eg

2014 eMedicine Emergency Medicine

182. Systemic Lupus Erythematosus (Follow-up)

. [ ] Patients with class III or IV disease, as well as those with a combination of class V and class III or IV disease, generally undergo aggressive therapy with glucocorticoid drugs and immunosuppressants. [ ] Immunosuppressive therapy consists of induction and maintenance therapy. Induction therapy involves potent immunosuppressive drugs (eg, mycophenolate mofetil, cyclophosphamide) to achieve remission; these drugs are generally used for 3 months to 1 year, with an average of 6 months’ treatment having (...) endothelial function, which may reduce cardiovascular disease. [ , , ] No diet-based treatment of SLE has been proven effective. Patients with SLE should be reminded that activity may need to be modified as tolerated. Specifically, stress and physical illness may precipitate SLE flares. Additionally, persons with SLE should wear sunscreen and protective clothing or avoid sun exposure to limit photosensitive rash or disease flares. Consultations The multisystemic nature of SLE often requires involvement

2014 eMedicine Emergency Medicine

183. Efficacy and Safety Study of Kinerase® for Treatment of Cutaneous Facial Photodamage

: Male and female subjects older than 35 years of age and less than 65 years of age. Subjects with mild, moderate or severe facial photodamage as assessed by a 10-point scale. Subjects willing to sign an informed consent and adhere to all protocol requirements. Exclusion Criteria: Male and female subjects with suspected porphyria, systemic or cutaneous erythematosus lupus, or any other photosensitizing disorder or drug-induced photosensitization. Subjects with chronic or recurring skin disease

2013 Clinical Trials

184. Efficacy and Safety of Kinetin 0.1% for Treatment of Skin Photoaging

requirements. Exclusion Criteria: Suspected porphyria, systemic or cutaneous lupus erythematosus, or any other photosensitizing disorder or drug-induced photosensitization Chronic or recurring skin disease or disorder Any active infectious skin disorder (Herpes simplex, molluscum contagiosum, and facial warts) Skin cancer of the facial tissues Any laser/IPL/ chemical peel in the 2 months preceding the screening visit History of Isotretinoin use, 6 months prior to the screening disease Topical tretinoin

2013 Clinical Trials

185. Sun exposure behavior and protection: recommendations for travelers. Full Text available with Trip Pro

populations at increased risks of drug-induced photosensitivity reactions and UV-induced skin cancers; and recommend several effective photoprotection strategies for travelers, Internet search engines were queried with the key words as search terms to examine the latest references on photoprotection and the epidemiology of UV-associated skin cancers.Observational studies have demonstrated that the public knows little about proper sunscreen protection, selection, and use, and often abuses sunscreens (...) for intentional UV overexposures. Cohort studies have identified special populations at increased risks of UV-associated skin cancers without the proper use of sunscreens and photoprotective clothing including children, fair-skinned persons, patients taking photosensitizing drugs, and organ transplant recipients (OTRs). Clinical investigations support the regular use of broad-spectrum sunscreens to prevent the development of premalignant actinic keratoses (AK) in all sun-exposed subjects, especially OTRs

2013 Journal of Travel Medicine

186. Cutaneous lupus erythematosus: first multicenter database analysis of 1002 patients from the European Society of Cutaneous Lupus Erythematosus (EUSCLE). (Abstract)

. The mean age at onset of disease was 43.0±15.7 years and differed significantly between the CLE subtypes. In 347 (34.6%) of the 1002 patients, two or more CLE subtypes were diagnosed during the course of the disease and 453 (45.2%) presented with LE-nonspecific manifestations. Drug-induced CLE and Sjögren's Syndrome had the highest prevalence in SCLE patients (13.1% and 14.0%, respectively). Photosensitivity was significantly more frequent in patients with ACLE, SCLE, and ICLE compared with those (...) , such as acute CLE (ACLE, 304 patients), subacute CLE (SCLE, 236 patients), chronic CLE (CCLE, 397 patients), and intermittent CLE (ICLE, 65 patients), from 13 European countries were collected and statistically analyzed by an SPSS database. The main outcome measures included gender, age at onset of disease, LE-specific and LE-nonspecific skin lesions, photosensitivity, laboratory features, and the criteria of the American College of Rheumatology (ACR) for the classification of systemic lupus erythematosus

2013 Autoimmunity reviews

187. Age-Related Macular Degeneration

is that straight lines appear crooked. Regular comprehensive eye exams can detect macular degeneration before the disease causes vision loss. Treatment can slow vision loss. It does not restore vision. NIH: National Eye Institute Definition (CSP) deterioration of the macula lutea in the retina; may be inherited, drug induced, or due to aging; leads to a severe loss of central vision while peripheral vision is retained. Concepts Disease or Syndrome ( T047 ) SnomedCT 422338006 , 302891003 LNC MTHU020821 English (...) (Macugen) Aflibercept (Eylea) X. Management: Slow progression of CNV-related Vision Loss Laser photocoagulation of subretinal blood vessels Photodynamic therapy Give IV photosensitive drug (wavelength specific) Expose eye to targeted wavelength to activate drug Experimental External beam Vitreoretinal microsurgery XI. Management: Visual aids Magnifiers Increased light sources in home environment XII. Prevention: General measures is key Control Decrease UV Light exposure ( ) Nutrition See s below

2015 FP Notebook

188. Vascular Inflammation in Psoriasis Trial (The VIP Trial)

treatment. Previous lack of response to a TNF-alpha antagonist and/or UV phototherapy that led to discontinuation of either of these therapies. Diagnosis of erythrodermic psoriasis, generalized or localized pustular psoriasis, medication-induced or medication-exacerbated psoriasis, or new onset guttate psoriasis. Diagnosis of other active skin diseases or skin infections (bacterial, fungal, or viral) that may interfere with evaluation of psoriasis. Cannot avoid UVB phototherapy for at least 14 days (...) . statin), dose and form of medication must be stable for 90 days prior to week 0 and remain stable throughout the duration of the study. History of photosensitivity of medical condition that may be exacerbated by UV exposures such as lupus or dermatomyositis Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor. Please refer

2012 Clinical Trials

189. Photoprovocation Testing in Subjects With Cutaneous Lupus

are not capable of giving written informed consent prior to enrolling in the study. Participants who have undergone any recent phototesting, or phototherapy exposure, or those who are suspected of having a drug-induced photosensitivity. Female participants who are pregnant or breastfeeding will be excluded from the study. This will be determined by patient self-reporting. Contacts and Locations Go to Information from the National Library of Medicine To learn more about this study, you or your doctor may (...) Information provided by (Responsible Party): University of Pennsylvania Study Details Study Description Go to Brief Summary: Photosensitivity is well documented among lupus patients and is one of the diagnostic criteria for systemic lupus erythematosus (SLE). Photosensitivity is highly prevalent in lupus and has a wide range of clinical presentations. However, photosensitivity is a poorly defined in lupus and its pathogenesis is not well understood. The purpose of this study is to characterize the early

2012 Clinical Trials

190. Skin Lesions in Dialysis - Part 2

to scar, and usually do not itch. Acute Cutaneous Lupus Erythematosus (ACLE); Confluent erythema and edema, erythematous macules and papules that eventually become confluent and occur in areas exposed to the sun and can be triggered by sun exposure. Subacute Cutaneous Lupus Erythematosus (SCLE); is a nonscarring, non–atrophy-producing, photosensitive dermatosis. SCLE may also occur in Sjögren syndrome, associated with deficiency of the second component of complement (C2d) or it may be drug induced. 50 (...) Skin Lesions in Dialysis - Part 2 Renal Fellow Network: Skin Lesions in Dialysis - Part 2 | | | | | Monday, March 25, 2013 Skin Lesions in Dialysis - Part 2 Phototoxic skin disorders in renal failure: Patients with renal failure or ESRD secondary SLE can have a photosensitive skin rash. For example: Discoid Lupus Erythematosus (DLE); these lesions are thick and scaly, plug the hair follicles, appear usually on surfaces of the skin exposed to sun (but can occur in non-exposed areas), tend

2013 Renal Fellow Network

191. Autoimmune Disorders

with an unaltered autoantigen (eg, antibodies to streptococcal M protein may cross-react with human heart muscle). Autoantigens normally sequestered from the immune system can become exposed and cause an autoimmune reaction (eg, systemic release of melanin-containing uveal cells after eye trauma triggers sympathetic ophthalmia). Autoantigens may be altered chemically, physically, or biologically: Chemical: Certain chemicals can bind with body proteins, making them immunogenic, as occurs in drug-induced (...) . Physical: For example, ultraviolet light induces keratinocyte apoptosis and subsequent altered immunogenicity of autoantigens, resulting in photosensitivity, as can occur in . Biologic: For example, in animal models, persistent infection with an RNA virus that combines with host tissues alters autoantigens biologically, resulting in an autoimmune disorder resembling . Genetic factors Relatives of patients with autoimmune disorders often also have autoantibodies. The specificity of autoantibodies

2013 Merck Manual (19th Edition)

192. Hyperpigmentation

etardation of growth, and sensorineural D eafness), or xeroderma pigmentosum. Drug-induced hyperpigmentation Changes are usually diffuse but sometimes have drug-specific distribution patterns or hues (see Table: ). Mechanisms include Increased melanin in the epidermis (tends to be more brown) Melanin in the epidermis and high dermis (mostly brown with hints of gray or blue) Increased melanin in the dermis (tends to be more grayish or blue) Dermal deposition of the drug, metabolite, or drug–melanin (...) complexes (usually slate or bluish gray) Drugs may cause secondary hyperpigmentation. For example, focal hyperpigmentation frequently occurs after drug-induced (also known as lichenoid drug eruption). Table Hyperpigmentation Effects of Some Drugs and Chemicals Substance Effect Drugs Amiodarone Slate-gray to violaceous discoloration of sun-exposed areas; yellowish brown deposits in the dermis Antimalarials Yellow-brown to gray to bluish black discoloration of pretibial areas, face, oral cavity, and nails

2013 Merck Manual (19th Edition)

193. Acne Vulgaris

concomitantly with oral antibiotics. Doxycycline and minocycline are first-line drugs; both can be taken with food. Tetracycline is also a good first choice, but it cannot be taken with food and may have lower efficacy than doxycycline and minocycline . Doxycycline and minocycline dosage is 50 to 100 mg po bid. Doxycycline may cause photosensitivity, and minocycline may have more adverse effects with chronic use, including drug-induced lupus and hyperpigmentation. Tetracycline dosage is 250 or 500 mg po bid (...) , and spironolactone (beginning at 50 mg po once/day, increased to 100 mg po once/day after a few mo if needed) is another anti-androgen that is occasionally useful in women. Various light therapies, with and without topical photosensitizers, have been used effectively, mostly for inflammatory acne. Treatment should involve educating the patient and tailoring the plan to one that is realistic for the patient. Treatment failure can frequently be attributed to lack of adherence to the plan and also to lack of follow

2013 Merck Manual (19th Edition)

194. A Double Blinded, Prospective, Randomized, Vehicle Controlled Multi-center Study of Photodynamic Therapy With Visonac® Cream in Patients With Acne Vulgaris

. Fitzpatrick skin type I through VI, Patients with 25 to 75 inflammatory lesions (papules, pustules, and nodules) on the face. Patients with 20 to 100 non-inflammatory lesions (open and closed comedones) on the face. Exclusion Criteria: Patients with acne conglobata, acne fulminans, secondary acne (chloracne, drug-induced acne, etc.) Patients with more than 3 nodules on the face. Patient is the investigator or any sub investigator, research assistant, pharmacist, study coordinator, other staff or relative (...) regimen (as described under inclusion criteria) while on treatment. Pregnancy. Nursing. Participation in other clinical studies either currently or within the last 30 days. Patients with porphyria. Patients with cutaneous photosensitivity. Known allergy to MAL, to a similar PDT compound, or to excipients of the cream Patients using testosterone, any other systemic hormonal treatment or hormonal contraceptives solely for control of acne. Patients who have received topical treatments for their facial

2011 Clinical Trials

195. Analgesic Full Text available with Trip Pro

and is believed to be devoid of any activity on dopamine, serotonin, or histamine receptors. It is not addictive, and tolerance usually does not develop. However, tolerance may develop in single cases. Other uses [ ] Topical analgesia is generally recommended to avoid systemic side-effects. Painful joints, for example, may be treated with an - or -containing gel (The labeling for topical diclofenac has been updated to warn about drug-induced hepatotoxicity. ); also is used . , an , and may be injected (...) and cancer. Related to piroxicam. As per diclofenac. PO. No data. and . Photosensitivity and other AEs typical of NSAIDs. Prodrug to . As per diclofenac. PO. No data. As per diclofenac. As per diclofenac. Comes in free form, aluminium and lysine salt forms; fairly insoluble in water (1 in 300); highly soluble (1 in 5) in alcohol; degrades on contact with air. Salicylate. Irreversibly inhibits and ; hence inhibiting prostaglandin synthesis. PO, IM, IV, rectal Bioavailability = 80–100%; protein binding

2012 Wikipedia

196. List of cutaneous conditions

are that present with cutaneous manifestations. (calomel disease, erythredemic polyneuropathy, pink disease) (pustular drug eruption, toxic pustuloderma) (bullous drug eruption, generalized bullous fixed drug eruption, multilocular bullous fixed drug eruption) (palmoplantar erythrodysesthesia syndrome) (drug-induced lichen planus, lichenoid drug eruption) (erythema multiforme minor–erythema multiforme von Hebra) (linear IgA dermatosis) (includes , , , , and ) (Lyell's syndrome) Endocrine-related [ ] See also

2012 Wikipedia

197. Systemic lupus erythematosus

that usually occurs in people being treated for a long-term illness. Drug-induced lupus mimics SLE. However, symptoms of drug-induced lupus generally disappear once the medication that triggered the episode is stopped. More than 38 medications can cause this condition, the most common of which are , , , , and . Non-systemic forms of lupus Discoid (cutaneous) lupus is limited to skin symptoms and is diagnosed by biopsy of rash on the face, neck, scalp or arms. Approximately 5% of people with DLE progress (...) autoimmune diseases, and may occur in normal individuals. Subtypes of antinuclear antibodies include and anti-double stranded (dsDNA) antibodies (which are linked to SLE) and (which are linked to drug-induced lupus). Anti-dsDNA antibodies are highly specific for SLE; they are present in 70% of cases, whereas they appear in only 0.5% of people without SLE. The anti-dsDNA antibody also tend to reflect disease activity, although not in all cases. Other ANA that may occur in people with SLE are (which also

2012 Wikipedia

198. Solar urticaria

Academy of Dermatology . 59 (6): 909–20, quiz 921–2. : . . Ring, Johannes (2005). . Springer. p. 170. . Gardeazabal, J; González-Pérez, R; Bilbao, I; Alvarez-Hernández, MI; Aguirre, A; Díaz-Pérez, JL (1998). "Solar urticaria enhanced through clothing". Photodermatology, Photoimmunology & Photomedicine . 14 (5–6): 164–6. : . . Yap, LM; Foley, PA; Crouch, RB; Baker, CS (August 2000). "Drug-induced solar urticaria due to tetracycline". The Australasian Journal of Dermatology . 41 (3): 181–4 (...) . Other rare side effects can be and glucose instability issues. Also, if a large area of the body is suddenly exposed the person may be subject to an . Once free of exposure, the rash will usually fade away within several hours; rare and extreme cases can take a day or two to normalize depending on severity of the reaction. Causes [ ] Solar urticaria is an -mediated hypersensitivity that can be introduced through primary or secondary factors, or induced by exogenous photosensitization. Primary SU

2012 Wikipedia

199. Non-steroidal anti-inflammatory drug Full Text available with Trip Pro

status and strategy of NSAIDs-induced small bowel injury". Journal of Gastroenterology . 44 (9): 879–888. : . . . Guo, Wei; Cheng, Ze-yu; Zhu, Yi-zhun (October 2013). . Acta Pharmacologica Sinica . 34 (10): 1284–1291. : . . . . Thomas MC (February 2000). "Diuretics, ACE inhibitors and NSAIDs—the triple whammy". The Medical Journal of Australia . 172 (4): 184–5. . . De Broe ME, Elseviers MM (February 1998). "Analgesic nephropathy". . 338 (7): 446–52. : . . . Moore DE (2002). "Drug-induced cutaneous (...) ). "Acetaminophen overdose in pregnancy". Southern Medical Journal . 98 (11): 1118–22. : . . . Dreillard, Audrey (2 March 2009). . (in French) . Retrieved 1 June 2009 . Kowalski ML, Makowska JS (2015). . Allergy Asthma Immunol Res . 7 (4): 312–320. : . . . Auriel E, Regev K, Korczyn AD (2014). Nonsteroidal anti-inflammatory drugs exposure and the central nervous system . Handb Clin Neurol . Handbook of Clinical Neurology. 119 . pp. 577–84. : . . . Woessner KM, Castells M (2013). "NSAID single-drug-induced

2012 Wikipedia

200. Evaluation of Efficacy and Safety of Adapalene 0.1%/Benzoyl Peroxide 2.5% Gel in the Treatment of Acne Vulgaris

(chloracne, drug-induced acne, etc.), Subjects with known or suspected allergy to one of the investigational products (see package insert and/or investigator brochure), Subjects who have pathological conditions photosensitive porphyria, SLE, LED, solar polymorphous eruption, actinic prurigo, solar urticaria, etc. Subjects with a beard or other facial hair that might interfere with study assessments, Subjects who foresee intensive UV exposure during the study (mountain sports, UV radiation, sunbathing

2010 Clinical Trials

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