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Evaluation of the Photosensitive Patient
Published in Henry W. Lim, Nicholas A. Soter, Clinical Photomedicine, 2018
Thomas Meola, Henry W. Lim, Nicholas A. Soter
In rare cases, a photodermatosis such as solar urticaria or the photoinduced lesions of lupus erythematosus may be associated with systemic symptoms. Therefore, it is appropriate to question photosensitive patients about symptoms such as shortness of breath or arthralgias, which may be associated with the eruption.
Novel Developments in Photoprotection: Part II
Published in Henry W. Lim, Herbert Hönigsmann, John L. M. Hawk, Photodermatology, 2007
André Rougier, Sophie Seite, Henry W. Lim
Therefore, these experiments confirmed that the different parts of the UV spectrum could elicit SU. Moreover, it was found that most of the patients react to very low doses of UV, particularly in the UVA domain, confirming the extreme skin sensitivity of this photodermatosis. The results also indicate that the use of broad-spectrum sunscreens with highly efficient UV filters can be considered as an option in the management of patients with SU with action spectra in the UV range. For those with visible light sensitivity, physical agents such as opaque clothings are the only available external photoprotective measure at this time.
Metabolic activation of tyrosine kinase inhibitors: recent advance and further clinical practice
Published in Drug Metabolism Reviews, 2023
Miao Yan, Wenqun Li, Wen-Bo Li, Qi Huang, Jing Li, Hua-Lin Cai, Hui Gong, Bi-Kui Zhang, Yi-Kun Wang
Skin toxicity is one of the most concerning adverse reactions of TKI treatment, which affects the quality of life and treatment compliance. TKIs display a considerable phototoxic potential, causing photodermatosis or other dermal adverse reactions. Dermatological toxicities are among the most common toxicities of ibrutinib (Ghasoub et al. 2020; Sibaud et al. 2020). CYP3A4/5-mediated metabolic bioactivation of lapatinib generated chemically reactive N-dealkylated lapatinib and O-dealkylated lapatinib. N-dealkylated lapatinib had a clear photosensitizing potential to exert both phototoxic and photogenotoxic effects toward dermal cells, as elucidated by the 3T3 NRU assay and the comet assay, respectively. N-dealkylated lapatinib exhibited higher photogenotoxicity than parent lapatinib through oxidation of purine bases, as revealed by the detection of 8-Oxo-dG (García-Lainez et al. 2021). N- and O-dealkylated lapatinib protein adduction was evaluated by fluorescence, ultrafast spectroscopy, and molecular dynamics simulations. Lapatinib-protein complexation was the first step involved in several hypersensitivity reactions and photosensitivity disorders (Andreu et al. 2020).
Between a rock and a hard place: management of systemic lupus erythematosus and porphyria cutanea tarda
Published in Journal of Dermatological Treatment, 2022
Timothy Nyckowski, Alexandra Grammenos, Alisa Vinokurov, Rajiv Nathoo
Porphyria cutanea tarda (PCT), the most common porphyria, is a rare photodermatosis characterized by fragile, hemorrhagic bullae and erosions with associated milia, hyperpigmentation, and hypertrichosis (1–3). PCT results from a decrease in hepatic uroporphyrinogen decarboxylase (UROD) activity yielding elevated urine porphyrin levels necessary for diagnosis. Underlying systemic diseases including hepatitis C, HIV, alcohol abuse, hemochromatosis, and exogenous hormone production/replacement often trigger PCT (1,3).
Prospects of topical protection from ultraviolet radiation exposure: a critical review on the juxtaposition of the benefits and risks involved with the use of chemoprotective agents
Published in Journal of Dermatological Treatment, 2018
Nilutpal Sharma Bora, Bhaskar Mazumder, Pronobesh Chattopadhyay
Long-term exposure of UV radiation elevates the risk of basal cell carcinoma, squamous cell carcinoma, and malignant melanoma. Ultraviolet radiation exposure also triggers many specific responses like phototoxic and photoallergic reactions, autoimmune diseases like lupus erythematous, idiopathic photodermatosis and varieties of skin cancers (6). Melanoma, non-melanoma cutaneous neoplasia, and preneoplasic disorders are other adverse effects of ultraviolet radiation exposure (7).