Piroxicam-induced photosensitivity

During the last 3 years, 9 patients with a photosensitive eruption related to piroxicam therapy were seen. In all but one, it occurred within 4 days of first exposure to the drug. 7 patients required systemic corticosteroids, and 2 hospitalization. Clinical, histological and provocation studies were not conclusive in classifying the eruption as photoallergic or phototoxic. Experimental studies including photohaemolysis, Bacillus subtilis culture and nuclear magnetic resonance showed: (i) in irradiated piroxicam solutions, there was more haemolysis; (ii) in irradiated Petri dishes, piroxicam solutions showed greater inhibition of growth of B. subtilis; (iii) Piroxicam's NMR spectrum is not modified after irradiation. The results provide evidence of piroxicam phototoxic potential.