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Drug-induced Photosensitivity

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121. Daylight-PDT With MAL for AK and Photodamaged Skin

with clinically relevant suppression of the immune system (e.g. drug induced, infection) or organ transplant patients Pregnancy or lactation Planned aesthetic treatments in the face in the next 24 months (filler, peeling, botulinumtoxin, skin resurfacing) Known intolerance or allergy to MAL or to any other ingredient of Metvix® 160mg/g cream Known intolerance to Actinica® lotion Photosensitivity Suspected lack of compliance (e.g. due to dementia) Simultaneous participation in another clinical study (...) study investigating the clinical efficacy of repetitive daylight-PDT with MAL compared to cryosurgery in regard to prophylaxis and treatment of AKs in the face. Patients will be randomly allocated to treatment groups. 5 PDT treatment sessions (visits 1-5) will be performed within 18 months. In the control group, cryosurgery will be performed at visit 1, and in case of non-cleared or newly occurred AKs at visits 2-5. Before application of the photosensitizer, an organic sunscreen (Actinica® lotion

2016 Clinical Trials

122. Multimodal Imaging in Central Serous Chorioretinopathy

étant dans la période d'exclusion d'une autre étude ou prévue par le "fichier national des volontaires" Presence of transparent medium opacity damaging images quality Previous photosensitivity Recent treatment with PhotoDynamic Therapy (PDT) Use of drugs inducing photosensitivity 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

2016 Clinical Trials

123. Venus Versa Diamondpolar Applicator Treatment Followed by AC Dual Applicator Treatment for Facial Acne Vulgaris

and nursing. Patients with cystic acne, acne conglobata, acne fulminans, or secondary acne (chloracne, drug-induced acne, etc) Diseases which may be stimulated by light at the wavelengths used, such as history of Systemic Lupus Erythematosus, Porphyria, and Epilepsy. Patients with history of diseases stimulated by heat, such as recurrent Herpes Simplex in the treatment area, may be treated only following a prophylactic regimen. Poorly controlled endocrine disorders, such as Diabetes or Polycystic Ovary (...) Syndrome. Any active condition in the treatment area, such as sores, Psoriasis, eczema, and rash. Tattoos, scars or piercings in the treated area. History of skin disorders, keloids, abnormal wound healing, as well as very dry and fragile skin. • Use of medications, herbs, food supplements, and vitamins known to induce photosensitivity to light exposure at the wavelengths used, such as Isotretinoin (Accutane) within the last six months, tetracyclines, or St. John's Wort within the last two weeks. Any

2016 Clinical Trials

124. Autologous Polyclonal Regulatory T Cell Therapy (Tregs) In Lupus

stage renal disease (estimated glomerular filtration rate [eGFR] < 20 ml/min/1.73m^2 using the CKD-EPI equation [53]). Drug induced lupus. Hemoglobin < 10 g/dL. White blood cell (WBC) count < 2,500/ mm^3 (equivalent to < 2.5 x109/L). Lymphocyte count < 625/mm^3 (equivalent to < 0.625 x109/L). Absolute neutrophil count < 1,500/mm3 (equivalent to < 1.5 x109/L). Platelets < 75,000/mm^3 (equivalent to < 75 x 109/L). Liver function test (aspartate aminotransferase [AST], alanine aminotransferase [ALT (...) activity score. Histopathologic confirmation is required unless the active lesions are of the same morphology to previously histologically proven cutaneous lupus lesions. The cutaneous lupus lesions must include any of the following subtypes: Acute cutaneous lupus including maculopapular lupus rash and photosensitive lupus rash, Subacute cutaneous lupus, Chronic cutaneous lupus including discoid lupus and hypertrophic (verrucous) lupus, Lupus timidus Positive test for Epstein-Barr virus (EBV) antibody

2015 Clinical Trials

125. Psoriasis Microbiome and Phototherapy

or localized pustular psoriasis, medication-induced or medication-exacerbated psoriasis, or new onset guttate psoriasis. Cannot discontinue or avoid topical therapies for psoriasis for at least 14 days prior to the Baseline (Week 1) visit and during the study other than on face, underarms, or groin. Cannot discontinue or avoid UVB phototherapy or Excimer laser for at least 14 days prior to the Baseline (Week 1) visit. Subject is receiving therapy for psoriasis that requires a wash out period of more than (...) /her medical history. Subject is a candidate for phototherapy. Subject has at least one psoriatic plaque measuring at least 6cm x 2cm located on either the arms or the legs (excluding intertriginous areas such as the axilla and inguinal folds) Able and willing to give written informed consent and to comply with requirements of this study protocol. Exclusion Criteria: Subject has photosensitizing condition or other contraindication to phototherapy Diagnosis of erythrodermic psoriasis, generalized

2015 Clinical Trials

126. Rilutek - riluzole

: This reviewer finds the association of the alleviation of symptoms and the discontinuation of drug most compelling with respect to a causal relationship of the Drug to ILD. The findings of immune- or hypersensitivity findings are suggestive but nonspecific. The value of the Drug Induced Lymphocyte Stimulation Test findings is uncertain give the low sensitivity (and possibly specificity) of the test (1) . 4. Comments This Medical Reviewer agrees with the wording provided by the Sponsor for the CBE (...) , Okubo T, Hiroshige S, Takenaka R, Ono E, Ueno T, Nureki S, Ando M, Miyazaki E, Kumamoto T. Drug-induced lymphocyte stimulation test is not useful for the diagnosis of drug-induced pneumonia. Tohoku J Exp Med 2007 May;212(1):49-53. Application Type/Number Submission Type/Number Submitter Name Product Name -------------------- -------------------- -------------------- ------------------------------------------ NDA-20599 SUPPL-13 SANOFI AVENTIS US LLC RILUTEK (RILUZOLE) 50MG TABS

2009 FDA - Drug Approval Package

127. Systemic Lupus Erythematosus (Diagnosis)

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.com

128. Morphea (Diagnosis)

infection and morphea based on serologic or polymerase chain reaction data. [ , , ] Vaccination: Morphealike lesions have also been reported to occur following vaccinations, including BCG, tetanus, and mumps-measles-rubella vaccinations. Whether the vaccinations themselves or the trauma from the injections was the inciting event is not clear. Drug-induced morphea: This is only rarely reported (ie, from bisoprolol, bleomycin, D-penicillamine, L-5-hydroxytryptophane, balicatib). [ , ] Trauma: Some morphea (...) , Schmitt A, Pfaltz M, Kempf W. Borrelia in granuloma annulare, morphea and lichen sclerosus: a PCR-based study and review of the literature. J Cutan Pathol . 2010 May. 37(5):571-7. . Peroni A, Zini A, Braga V, Colato C, Adami S, Girolomoni G. Drug-induced morphea: report of a case induced by balicatib and review of the literature. J Am Acad Dermatol . 2008 Jul. 59(1):125-9. . Hanami Y, Ohtsuka M, Yamamoto T. Paraneoplastic eosinophilic fasciitis with generalized morphea and vitiligo in a patient

2014 eMedicine.com

129. Nevi of Ota and Ito (Diagnosis)

or plaques Photodistribution, especially on face Elongation of rete ridges; basal layer hyperpigmentation; slight increase of melanocyte number along basal layer Phytophotodermatitis Acquired; exposure to certain plants or cosmetics Gray-to-brown macules and patches Photodistribution, according to sites of contact with photosensitizer Dermal melanophages Drug-induced hyperpigmentation Acquired; following drug exposure (eg, minocycline, amiodarone, gold) Variable according to offending drugs Variable

2014 eMedicine.com

130. Neurosyphilis (Diagnosis)

that became known as the great imitator. Early treatments, in the age of modern management, included prescription mercury, iodides, guaiacum, or arsenicals with bismuth (1909); suspension therapy; and fever therapy induced from malaria. [ ] The malariotherapy (fever therapy), ironically, was heralded as a revolutionary breakthrough, despite itself being a fatal disease. This was widely adopted treatment until the introduction of penicillin (PCN) in the 1950s; even then, the malariotherapy was thought

2014 eMedicine.com

131. Lupus Erythematosus, Subacute Cutaneous (Diagnosis)

of complement (C2d), or it may be drug-induced. SCLE is the most common subtype of CLE associated with Sjögren syndrome. [ ] Some patients with SCLE may also have (ACLE), if they have concomitant SLE, or the lesions of (DLE), and some may develop small-vessel vasculitis. (See the image below.) Early lesions of subacute cutaneous lupus erythematosus may simulate polymorphous light eruption. See , a Critical Images slideshow, to help recognize cutaneous manifestations of rheumatologic diseases. Patients (...) , Bahrami S, Callen JP. Golimumab-exacerbated subacute cutaneous lupus erythematosus. Arch Dermatol . 2012 Oct. 148(10):1186-90. . Lowe G, Henderson CL, Grau RH, Hansen CB, Sontheimer RD. A systematic review of drug-induced subacute cutaneous lupus erythematosus. Br J Dermatol . 2011 Mar. 164(3):465-72. . Durosaro O, Davis MD, Reed KB, Rohlinger AL. Incidence of cutaneous lupus erythematosus, 1965-2005: a population-based study. Arch Dermatol . 2009 Mar. 145 (3):249-53. . Durosaro O, Davis MD, Reed KB

2014 eMedicine.com

132. Paraneoplastic Diseases (Diagnosis)

of hyperkeratosis and papillomatosis of the epidermis. Acanthosis is seldom present, and hyperpigmentation is related to hyperkeratosis, not melanin deposition; therefore, the condition is misnamed. Not all patients with AN have a paraneoplastic syndrome. Familial AN, drug-induced AN, AN occurring in hyperinsulinemic states (eg, diabetes, obesity), AN associated with polycystic ovary disease, and AN associated with a spectrum of autoimmune disease in women should be considered before AN is determined (...) are far more common than malignant associations, should be excluded first. Thus, the diagnosis of paraneoplastic AI becomes a diagnosis of exclusion. The differential diagnosis of AI includes xerosis or asteatotic eczema. Some drugs, including lansoprazole, niacin, retinoids, and the statin class of lipid-lowering drugs, cause clinically significant, generalized xerosis. As a paraneoplastic syndrome, AI is often impossible to distinguish from drug-induced ichthyosis; thus, the patient's history

2014 eMedicine.com

133. Oral Manifestations of Systemic Diseases (Diagnosis)

, purpura, paraneoplastic pemphigus, Sweet syndrome) or therapy-induced lesions (eg, drug reactions, graft vs host disease). [ , ] Oral manifestations are more common in acute leukemias than in chronic leukemias. [ ] Gingival hypertrophy and hyperplasia are most commonly associated with acute myelogenous leukemia and acute promyelocytic leukemia. [ ] The gingiva are friable, edematous, and erythematous. [ , ] Thrombocytopenia commonly manifests as petechiae and ecchymoses on the mucosal surfaces (...) phenotype and severity of symptoms vary greatly and include nonimmune hydrops fetalis in utero, scarring and deformities, hemolytic anemia, corneal scarring, and blindness. Cutaneous manifestations include severe photosensitivity with blistering hypertrichosis. [ ] In the oral cavity, erythrodontia, a red-brown discoloration of the teeth, is pathognomonic for congenital erythropoietic porphyria. [ , ] Teeth appear bright red with exposure to UV fluorescence. [ ] It has been proposed that erythrodontia

2014 eMedicine.com

134. Pseudoporphyria (Diagnosis)

other authors have corroborated these findings. Other mechanisms have been proposed to explain the role of ultraviolet or visible light radiation in drug-induced pseudoporphyria. An alternative theory is based on the finding that exogenous photosensitizers are deposited along the endothelium of blood vessels of lesional and nonlesional skin. An immune response targeted against antigens is proposed to develop after phototoxic injury to the dermal microvascular endothelium. Dabski and Beutner proposed (...) . . Stenberg A. Pseudoporphyria and sunbeds. Acta Derm Venereol . 1990. 70(4):354-6. . Wilson CL, Mendelsohn SS. Pseudoporphyria and sunbeds, a coincidence in identical twins?. Br J Dermatol . 1991 Aug. 125(2):191. . Quaiser S, Khan R, Khan AS. Drug induced pseudoporphyria in CKD: A case report. Indian J Nephrol . 2015 Sep-Oct. 25 (5):307-9. . Keane JT, Pearson RW, Malkinson FD. Nalidixic acid-induced photosensitivity in mice: a model for pseudoporphyria. J Invest Dermatol . 1984 Mar. 82(3):210-3. . Dabski

2014 eMedicine.com

135. Pseudoporphyria (Overview)

other authors have corroborated these findings. Other mechanisms have been proposed to explain the role of ultraviolet or visible light radiation in drug-induced pseudoporphyria. An alternative theory is based on the finding that exogenous photosensitizers are deposited along the endothelium of blood vessels of lesional and nonlesional skin. An immune response targeted against antigens is proposed to develop after phototoxic injury to the dermal microvascular endothelium. Dabski and Beutner proposed (...) . . Stenberg A. Pseudoporphyria and sunbeds. Acta Derm Venereol . 1990. 70(4):354-6. . Wilson CL, Mendelsohn SS. Pseudoporphyria and sunbeds, a coincidence in identical twins?. Br J Dermatol . 1991 Aug. 125(2):191. . Quaiser S, Khan R, Khan AS. Drug induced pseudoporphyria in CKD: A case report. Indian J Nephrol . 2015 Sep-Oct. 25 (5):307-9. . Keane JT, Pearson RW, Malkinson FD. Nalidixic acid-induced photosensitivity in mice: a model for pseudoporphyria. J Invest Dermatol . 1984 Mar. 82(3):210-3. . Dabski

2014 eMedicine.com

136. Morphea (Overview)

infection and morphea based on serologic or polymerase chain reaction data. [ , , ] Vaccination: Morphealike lesions have also been reported to occur following vaccinations, including BCG, tetanus, and mumps-measles-rubella vaccinations. Whether the vaccinations themselves or the trauma from the injections was the inciting event is not clear. Drug-induced morphea: This is only rarely reported (ie, from bisoprolol, bleomycin, D-penicillamine, L-5-hydroxytryptophane, balicatib). [ , ] Trauma: Some morphea (...) , Schmitt A, Pfaltz M, Kempf W. Borrelia in granuloma annulare, morphea and lichen sclerosus: a PCR-based study and review of the literature. J Cutan Pathol . 2010 May. 37(5):571-7. . Peroni A, Zini A, Braga V, Colato C, Adami S, Girolomoni G. Drug-induced morphea: report of a case induced by balicatib and review of the literature. J Am Acad Dermatol . 2008 Jul. 59(1):125-9. . Hanami Y, Ohtsuka M, Yamamoto T. Paraneoplastic eosinophilic fasciitis with generalized morphea and vitiligo in a patient

2014 eMedicine.com

137. Cutaneous Manifestations of HIV Disease (Overview)

, an HIV-1 protease inhibitor. Previous Next: Photosensitivity and Drug-Induced Pigmentation A study by Vin-Christian et al found that photosensitivity in HIV-infected patients appears to be a manifestation of advanced disease. [ ] Most of the patients in that study were sensitive to ultraviolet B (UV-B) light; however, the patients who were most severely affected were sensitive to both UV-B and UV-A light. [ ] Photo-induced lichenoid drug reactions may occur in HIV-infected patients, particularly (...) those with dark skin. In addition, HIV-infected patients may experience drug-induced pigmentation of skin exposed to light. Previous Next: Miscellaneous Dermatologic Disorders The following dermatologic conditions may be associated with HIV disease: HIV-related CD8+ cutaneous pseudolymphoma: This is an inflammatory process that results from a massive infiltration of the skin by activated, oligoclonal, HIV-specific, cytotoxic T lymphocytes and is most often seen in those that are markedly

2014 eMedicine.com

138. Cutaneous Manifestations of HIV Disease (Treatment)

, an HIV-1 protease inhibitor. Previous Next: Photosensitivity and Drug-Induced Pigmentation A study by Vin-Christian et al found that photosensitivity in HIV-infected patients appears to be a manifestation of advanced disease. [ ] Most of the patients in that study were sensitive to ultraviolet B (UV-B) light; however, the patients who were most severely affected were sensitive to both UV-B and UV-A light. [ ] Photo-induced lichenoid drug reactions may occur in HIV-infected patients, particularly (...) those with dark skin. In addition, HIV-infected patients may experience drug-induced pigmentation of skin exposed to light. Previous Next: Miscellaneous Dermatologic Disorders The following dermatologic conditions may be associated with HIV disease: HIV-related CD8+ cutaneous pseudolymphoma: This is an inflammatory process that results from a massive infiltration of the skin by activated, oligoclonal, HIV-specific, cytotoxic T lymphocytes and is most often seen in those that are markedly

2014 eMedicine.com

139. 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.com

140. Absence Seizures (Treatment)

by carbamazepine. N Engl J Med . 1985 Oct 10. 313(15):916-21. . Liu L, Zheng T, Morris MJ, Wallengren C, Clarke AL, Reid CA, et al. The mechanism of carbamazepine aggravation of absence seizures. J Pharmacol Exp Ther . 2006 Nov. 319(2):790-8. . Vendrame M, Khurana DS, Cruz M, Melvin J, Valencia I, Legido A, et al. Aggravation of seizures and/or EEG features in children treated with oxcarbazepine monotherapy. Epilepsia . 2007 Nov. 48(11):2116-20. . Guerrini R, Belmonte A, Genton P. Antiepileptic drug-induced (...) , with the faster frequencies seen in syndromes with older age of onset. Bursts of generalized polyspikes and waves (multiple spike-and-slow-wave complexes) may also be seen, [ ] especially during sleep and in syndromes with older age of onset. The onset and ending of these seizures are abrupt; no postictal EEG slowing is noted. Hyperventilation often provokes these seizures and should be a routine part of all EEGs in children. Photosensitivity may be present in idiopathic generalized epilepsies and is more

2014 eMedicine.com

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