Yuko Kurumaji

Scarified photopatch testing in lomefloxacin photosensitivity

We report the results of sacrified photopatch testing in 3 patients with photosensitivity to lomefloxacin, a new quinolone: antibacterial agent introduced onto the Japanese market in April 1990. The patients developed pruritic eczematous lesions on sun‐exposed areas 5 days to 3 weeks after they had started taking lomefloxacin. 2 cases reacted positively to lomefloxacin on scarified photopatch testing down to 0.1% pet., arid 1 patient down to 10% pet One of them also showed positive reactions on conventional photopatch testing; Scarified photopatch testing with 7 other pyridone carbonate derivatives in 2 of the 3 cases, however, did not show any positive reactions patch and scarified patch testing were negative in all patients. The clinical course, clinical and histological findings and results of skin tests in these patients suggest that photoallergic mechanisms arc involved. This is the 1st report of positive reactions on scarified photopatch testing, which appears to be a useful method of detecting the causative drug in drug‐induced photosensitivity.

Allergic photocontact dermatitis due to suprofen : photopatch testing and cross-reaction study

We report 5 cases of Photocontact dermatitis due to suprofen, a nonsteroidal anti‐inflammatory drug introduced to the Japanese market in 1989, and available as a 1% ointment. The patients developed pruritic eczematous lesions after applying the ointment for from 2 weeks to 3 months. All 5 patients reacted positively to photopatch testing with ultraviolet A (UVA) and suprofen down to 0.1–0.01% pet., and 3 patients showed positive reactions with ultraviolet B (UVB)and suprofen down to 1.0–0.1% Moreover, all patients showed a cross‐reaction with tiaprofenic acid, which has a very similar chemical structure to suprofen. However, there was no cross‐reaction between suprofen and ketoprofen. Prescribers should be aware of the existence of photocontact sensitivity due to these drugs.

Tiopronin‐induced Lichenoid Eruption in a Patient with Liver Disease and Positive Patch Test Reaction to Drugs with Sulfhydryl Group

A 62‐year‐old woman suffering from liver cirrhosis developed lichenoid eruptions after 2 years of treatment with tiopronin. The lesions healed spontaneously within a month after withdrawal of the drug. In patch testing, the patient reacted positively, not only to tiopronin, but also to captopril and D‐penicillamine, neither of which she had ever taken before. The provocation test was positive only to tiopronin, and its histological findings revealed lichenoid reaction. It is suggested that the sulfhydryl group may play a role in the etiology of tiopronin‐induced lichenoid drug eruption.

Photosensitivity in Atopic Dermatitis: Demonstration of Abnormal Response to UVB

It is a well‐known fact among clinicians that sunlight may exacerbate atopic dermatitis (AD), but little is known beyond that. In a preliminary study investigating this phenomenon, 19 patients with AD were selected for phototests. All of them had a normal minimal erythema dose (MED). However, 3 patients (15.7%) demonstrated abnormal cutaneous responses 24–72 h after provocation with ultraviolet light B (UVB). None of the patients had a positive response to pure ultraviolet light A (UVA) irradiation of up to 9 J/cm2. The photobiological results of this study confirm the existence of photosensitivity in AD and indicate that UVB wavelengths are responsible for it.

A Case of Secondary Syphilis with a Solitary Pulmonary Lesion

This study describes a case of secondary syphilis with a papular eruption and penile ulceration. A chest roentgenogram showed a solitary lesion in the left middle lung field. Histological examination revealed epithelioid cell granuloma in both the penile ulcer and the lung lesion. After antisyphilitic treatment, the lung lesion shrunk remarkably and at the same time the skin eruption and the systemic symptoms also improved.

Ampiroxican‐induced photosensitivity

Case Report A 69-year-old man presented with edematous erythematous eruptions, without pruritus, on sun-exposed areas, and numerous microvesicles on his hands and fingers. He had taken 2 doses of ampiroxicam (Flucam®) for a headache 2 days previously (totaling 27 mg). Except for contact dermatitis from a disinfectant nearly 40 years ago, he had no relevant past or family history. All laboratory findings were within normal limits. Phototesting was performed, using a Dermaray Model M-DMR-80 (Clinical Supply Co. Ltd, Gifu, Japan) (6), for UVA and UVB light sources. The following phototest results confirmed photosensitivity due to ampiroxicam, its action spectrum being in the UVA range: (i) initial phototests on his 1st visit showed abnormal erythematous reactions to UVA; (ii) subsequent phototests a week after the drug had been withdrawn

Chronic Actinic Dermatitis: A Clinical and Photobiological Study in 6 Japanese Patients

Chronic actinic dermatitis (CAD) has distinct clinical features different from polymorphous light eruption (PLE). In order to clarify the difference between CAD and PLE, not only in clinical histories and findings but also in photobiological and histopathological reactions to phototests, we investigated 6 Japanese patients with CAD and performed provocative phototests which are our standardized methods in diagnosing PLE. On provocative phototests in CAD, pruritic papules were reproduced with smaller doses of UVB, at longer hours after irradiation (48-72 h) and they lasted for more days than in patients with PLE. Our study demonstrated that although milder cases of CAD and severe cases of PLE could not be distinguished clearly based on photobiological reactions alone, typical cases of CAD showed completely different provocative phototest results from those of PLE.