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Photodermatitis from topical phenothiazines: A case series.

Claire Cariou1, Catherine Droitcourt1,2, Marie Noelle Osmont3

  • 1Department of Dermatology, CHU Pontchaillou, Rennes, France.

Contact Dermatitis
|March 4, 2020
PubMed
Summary
This summary is machine-generated.

Topical phenothiazines, especially isothipendyl, can cause significant photodermatitis and sensitization. Limiting their over-the-counter use is recommended to prevent severe reactions and cross-reactivity to other phenothiazines.

Keywords:
CAS no. 482-15-5CAS no. 60-87-7eczemaisothipendylphotoallergic contact dermatitisphotopatch testpromethazinetopical phenothiazines

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Area of Science:

  • Dermatology
  • Photodermatology
  • Pharmacovigilance

Background:

  • Contact photosensitivity to phenothiazines is a known issue in Europe.
  • Topical phenothiazines are commonly used as over-the-counter (OTC) treatments for insect bites and itching in France.

Purpose of the Study:

  • To document cases of photodermatitis resulting from the use of topical phenothiazines.

Main Methods:

  • A retrospective analysis of patients diagnosed with phenothiazine-induced contact dermatitis was conducted at French photodermatology centers.
  • Photopatch testing was performed on affected patients.

Main Results:

  • Fourteen patients presented with phenothiazine contact dermatitis, with 13 experiencing eruption spread to sun-exposed areas.
  • Isothipendyl was the most frequent cause of photodermatitis; promethazine cream also caused photoaggravated eczema.
  • Photopatch tests were positive for the causative phenothiazine in 9/9 cases, and for chlorpromazine and promethazine in a significant proportion of tested patients.

Conclusions:

  • The use of topical isothipendyl and promethazine, whether OTC or prescribed, should be restricted.
  • These agents can lead to severe reactions and sensitization, necessitating avoidance of other phenothiazines.