Doxycycline-Induced Phototoxicity
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《新英格兰医药杂志》
A 32-year-old man consulted his medical care provider in June because of persistent acne. Two months earlier he had been prescribed a benzoyl peroxide wash and doxycycline (100 mg twice daily). Four days after starting a new outdoor job, he noted burning and erythema on his cheeks, nose, and lips. The erythema intensified, blisters appeared on the lower lips, and the pain ranged from moderate to intense. Examination showed erythema on the face that was most intense on the cheeks, nose, and upper lip. The vermilion border of the lower lip appeared to have undergone impetiginization, with erosions and crusting. The lips and nasal passages were treated with mupirocin ointment, and 0.05 percent fluticasone propionate cream (group V topical corticosteroid) was prescribed for the face. Sunscreens typically do not block ultraviolet A rays well enough to prevent phototoxic reactions to drugs such as doxycycline. The patient was advised not to use doxycycline during the summer, especially at doses exceeding 150 mg per day. The patient made a complete recovery, with no residual pigmentation.
Thomas P. Habif, M.D.
Dartmouth Medical School
Hanover, NH 03755
Thomas P. Habif, M.D.
Dartmouth Medical School
Hanover, NH 03755