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Drug Toxicity: Allergic Reactions01:30

Drug Toxicity: Allergic Reactions

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Drug-related allergies are immune-mediated responses triggered by the administration of pharmacological agents. These hypersensitivity reactions are classified based on the immune mechanisms involved. The four primary types—Type I, II, III, and IV—are mediated by different immunological pathways and exhibit distinct clinical manifestations.Type I Hypersensitivity/ IgE-Mediated Reactions: Immunoglobulin E (IgE) immediately mediates Type I hypersensitivity reactions. Upon initial...
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Allergic reactions related to drugs are hypersensitivity responses driven by the immune system and bear no connection to the drug's therapeutic action. While drugs in isolation do not trigger an immune response, they can interact with endogenous proteins to form antigens. These antigens stimulate lymphocytes to produce antibodies. IgE-type antibodies attach themselves to mast cells. Upon subsequent exposure to the same stimulus, the antigen-antibody interaction is initiated, unleashing...
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Skin is the first line of defense and encounters a variety of microbes. Some pathogenic strains are often the cause of a broad range of infections of the skin and other body systems. These conditions can affect people of all ages and may have different causes, including genetic factors, infections, autoimmune reactions, environmental factors, and lifestyle choices.
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Skin cancer is a type of cancer that occurs when there is an abnormal growth of skin cells, usually triggered by damage to the DNA within the skin cells. It is primarily caused by exposure to ultraviolet (UV) radiation from the sun or artificial sources like tanning beds. Skin cancer is the most common type of cancer worldwide, and its incidence continues to rise.
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Type III hypersensitivity reactions occur when antigen–antibody complexes form and activate the complement system. Normally, these complexes help the clearance of antigens by phagocytes and red blood cells. However, when large numbers of immune complexes are present, they can deposit in tissues—particularly in the walls of blood vessels—leading to inflammation and tissue injury. These deposits trigger complement activation and neutrophil recruitment, resulting in serum...
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UVB-sensitive solar urticaria possibly associated with terbinafine.

Sandy Kuo, Raja K Sivamani1

  • 1University of California, Davis. rksivamani@ucdavis.edu.

Dermatology Online Journal
|March 25, 2014
PubMed
Summary

Solar urticaria causes skin reactions after sun exposure. A case report suggests terbinafine may trigger this rare condition, highlighting a potential drug-induced photosensitivity.

Area of Science:

  • Dermatology
  • Photobiology
  • Pharmacology

Background:

  • Solar urticaria is a rare photodermatosis causing hives upon light exposure.
  • It is characterized by erythema and whealing following ultraviolet (UV) and/or visible light exposure.
  • The exact mechanisms and triggers are not fully understood.

Observation:

  • A 25-year-old woman developed a pruritic, erythematous, and edematous reaction minutes after sun exposure.
  • This reaction occurred while she was undergoing treatment with terbinafine for onychomycosis.
  • The patient's symptoms were consistent with solar urticaria.

Findings:

  • Phototesting confirmed a UVB-sensitive urticarial reaction in the patient.
  • This case presents the first documented instance of possible terbinafine-associated solar urticaria.

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  • The findings suggest a potential link between terbinafine and the development of solar urticaria.

    • Implications:

    • This case highlights the importance of considering drug-induced photosensitivity in patients presenting with solar urticaria.
    • Terbinafine may be a potential trigger for solar urticaria in susceptible individuals.
    • Further research is warranted to elucidate the relationship between terbinafine and solar urticaria.