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FD9 > 97 - Phototoxicity and Photoallergy > Flashcards

97 - Phototoxicity and Photoallergy Flashcards

1
Q

Well-characterized examples of photosensitivity induced by endogeneous photosensitizers are the

A

Cutaneous porphyrias

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2
Q

Result of direct tissue injury caused by the phototoxic agent and radiation

A

Phototoxicity

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3
Q

Type IV delayed hypersensitivity response to a molecule that has been modified by absorption of protons

A

Photoallergy

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4
Q

Most of the photosensitivity induced by systemic medications are _____, whereas those induced by topical agents are _____

A

Phototoxicity

Photoallergy

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5
Q

Acute phototoxicity occurs within hours of exposure to the phototoxic agent and UV radiation. A notable exception to these kinetics is

A

Psoralen-induced phototoxicity

Acute response first appears after 24 hours, and peaks at 48 to 72 hours

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6
Q

Photoonycholysis has been reported with

A 
Doxycycline and other tetracyclines
Fluoroquinolones
Psoralens
Benoxaprofen
Clorazepate dipotassium
Olanzapine
Aripiprazole
Indapamide
Quinine
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7
Q

Asymptomatic blue-gray pigmentation on sun-exposed areas is associated with exposure to several agents

A 
Amiodarone
Chlorpromazine
Clozapine
Imipramine
Despiramine
Minocycline
Diltiazem
Silver
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8
Q

Can induce blue-gray pigmentation on sun-exposed areas such as face, frequently on sites of acne scars, forearms, and shins

A

Minocycline

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9
Q

Slate-gray pigmentation involves the nail lunulae, mucous membranes, and sclerae
Silver granules are deposited in the dermis

A

Argyria

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10
Q

Cutaneous changes of skin fragility, vesicles, and subepidermal blisters
Porphyrin profile is normal or in the upper range of normal

A

Pseudoporphyria

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11
Q

Most commonly reported causative agent of pseudoporphyria

A

Naproxen

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12
Q

Other drugs and treatment modality incriminated in pseudoporphyria

A 
Amiodarone
Beta-lactam antibiotics
Celecoxib
Ciprofloxacin
Cyclosporine
Diflunisal
Etretinate
Furosemide
Imatinib
Nabumetone
Nalidixic acid
NB UVB
Oral contraceptives
Oxaprozin
Ketoprofen
Mefenamic acid
Tetracyclines
Tiaprofenic acid
Torsemide
Voriconazole
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13
Q

Accelerated photo-induced changes has been uniquely described with

A

Voricanozole

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14
Q

Photodistributed telangiectasia has been reported with

A

Calcium channel blockers (nifedipine, amlodipine, felodipine, diltiazem)
Cefotaxime
Antidepressants (venlafaxine, escitalopram)

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15
Q

Lichenoid photosensitive eruption has been reported with

A

Doxycycline

Capecitabine

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16
Q

Persistence of photosensitivity and evolution to chronic actinic dermatitis has been reported with

A

Thiazides
Quinidine
Quinine
Amiodarone

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17
Q

Chronic effects are best exemplified by the manifestations in patients who received

A

Long-term PUVA chemotherapy

18
Q

Topical photosensitizing agents

Induce exaggerated UV response as a result of their irritant effect on skin

A

Fluorouracil

Retinoids

19
Q

Topical phototoxic agents

A

Fluoroscein
Furocoumarins
Rose bengal
Tar

20
Q

Present in limes, celery, figs, and parsnips

A

Furocoumarins

21
Q

Crude coal tar is well documented to produce a burning and stinging sensation on exposure to UVA known as

A

Tar smarts

22
Q

As a rule, the action spectra of systemic agents are in the UVA range; notable exceptions are _____, whose action spectra are in the visible light range

A

Porphyrins
Fluorescein
Other dyes

23
Q

Several pathways eventuate in the development of phototoxic tissue damage

A
  1. Photodynamic process
  2. Generation of photoproducts
  3. Binding to substrate
  4. Inflammatory mediators
  5. Apoptosis
24
Q

Involves absorption of radiation energy by the photosensitizer and formation of an excited molecule
Subsequent generation of reactive oxygen species result in tissue injury

A

Photodynamic process

25
Q

Generation of _____ induced by exposure to radiation can be responsible for tissue injury

A

Stable photoproducts

26
Q

An example of this mechanism is the covalent binding of 8-methoxypsoralen to pyrimidine bases of the DNA molecules upon exposure to UVA, which results in the formation of a crosslink between the DNA strands

A

Binding to substrate

27
Q

Biologically active products of complement activation, mast cell-derived mediators, eicosanoids, proteases, and polymorphonuclear leukocytes contribute to the development of phototoxicity

A

Inflammatory mediators

28
Q

In addition to generating reactive oxygen species, photodynamic therapy is also a potent inducer of

A

Apoptosis

29
Q

In the US, Canada, Europe and the UK, common photoallergens include

A 
UV filters (benzophenone-3, octocrylene, avobenzone, octinoxate)
Topical NSAIDs (ketoprofen, etofenamate)
30
Q

In China, _____ were the most common photoallergens

A

Chlorpromazine

Para-aminobenzoic acid

31
Q

All but one of the photoallergens (_____) are also phototoxic

A

Pyridoxine

32
Q

Phototesting and photopatch: reaction only at an irradiated site

A

Photoallergy

33
Q

Phototesting and photopatch: reaction of equal intensity at both irradiated and covered sites

A

Allergic contact dermatitis

34
Q

Phototesting and photopatch: reaction at both sites, but with a higher intensity at the irradiated site

A

Photoallergy and allergic contact dermatitis

35
Q

Phototesting and photopatch: well-defined erythema that resolves promptly

A

Irritant dermatitis

36
Q

Characterized by involvement of skinfolds on exposed areas, such as the nasolabial folds and the eyelids that receive minimal direct sunlight
Also involves exposed areas that are relatively sun protected, such as the postauricual areas and area under the chin

A

Airborne allergic contact dermatitis

37
Q

Occur at sites of contact, in both sun-exposed and sun-protected areas

A

Allergic contact dermatitis

Irritant contant dermatitis

38
Q

Manifests itself within a few hours of sun exposure as pruritic papules, plaques, and, uncommonly, vesicles on sun-exposed sites and resolves in a few days
Lack of exposure to photosensitizer

A

Polymorphous light eruption

39
Q

Chronically lichenified plaques on sun-exposed areas

Lack of exposure to photosensitizer

A

Chronic actinic dermatitis

40
Q

Appear within minutes of sun exposure as mildly pruritic urticaria and resolve within a few hours
Lack of exposure to photosensitizer

A

Solar urticaria

FD9 (108 decks)

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