ketoprofen photoallergic dermatitis

Ketoprofen Photoallergic Dermatitis: A Review

Ketoprofen photoallergic dermatitis is a type of skin reaction that occurs when the body's immune system reacts to ketoprofen, a nonsteroidal anti-inflammatory drug (NSAID), in the presence of sunlight. This condition is also known as photoallergic contact dermatitis.

Symptoms and Presentation

The symptoms of ketoprofen photoallergic dermatitis typically present as photoallergic dermatitis, which is a cell-mediated immune process [1]. The reaction usually occurs within minutes to hours after exposure to the sun or artificial light sources. Common symptoms include:

• Redness and inflammation of the skin
• Small blisters and exudate in affected areas
• Erythema (redness) accompanied by small blisters and exudate, as seen in cases where patients were exposed to ketoprofen-contaminated objects such as bandages [2]

Causes and Triggers

Ketoprofen photoallergic dermatitis is usually triggered by the use of topical or oral ketoprofen products. The condition can also be induced by exposure to ketoprofen-contaminated objects, such as bandages and other medical supplies [3].

Treatment and Management

The treatment of ketoprofen-induced photoallergic dermatitis involves discontinuation of ketoprofen, topical or systemic corticosteroids, and avoidance of sun exposure [4]. In some cases, additional treatments may be necessary to manage symptoms and prevent relapses.

Prevention and Awareness

To avoid ketoprofen photoallergic dermatitis, it is essential to use caution when handling ketoprofen products and to take steps to protect the skin from sunlight. This includes using sunscreen with a Sun Protection Factor (SPF) of at least 30, wearing protective clothing, and seeking shade or avoiding peak sun hours.

References

[1] TY Loh · 2016 · Cited by 34 — Ketoprofen-induced photosensitivity reactions usually present as photoallergic dermatitis, which is a cell-mediated immune process. [2] M Hindsén · 2004 · Cited by 60 — Relapses of photoallergic contact dermatitis in patients photoallergic to ketoprofen can be induced by ketoprofen-contaminated objects such as bandages and ... [3] T Nihira · 2019 · Cited by 6 — Erythema accompanied by small blisters and exudate in a rectangular area on both feet, corresponding to the shape of the compresses. Drug- ... [4] TY Loh · 2016 · Cited by 34 — Ketoprofen-induced photosensitivity reactions usually present as photoallergic dermatitis, which is a cell-mediated immune process. [5] Apr 20, 2024 — Ketoprofen-induced photosensitivity reactions usually present as photoallergic dermatitis, which is a cell-mediated immune process.

Common Signs and Symptoms of Ketoprofen Photoallergic Dermatitis

Ketoprofen photoallergic dermatitis (PACD) is a skin condition that occurs when the body reacts to ketoprofen, a non-steroidal anti-inflammatory drug (NSAID), in combination with sunlight. The symptoms of PACD can vary from person to person but often include:

• Erythema: Redness and inflammation of the skin, which can be itchy and painful [7].
• Small blisters and exudate: Small blisters or oozing lesions on the skin, particularly in sun-exposed areas [1].
• Itching (pruritus): Severe itching sensations on the affected skin area [7].
• Edema: Swelling of the skin due to fluid accumulation [8].
• Papulovesicular eruptions: Small, raised bumps or vesicles on the skin surface [8].

In some cases, PACD can also cause more severe symptoms, such as:

• Systemic reactions: Fever, rigors (shivering), diarrhea, and liver dysfunction are rare but possible complications of PACD [7].
• Erythema extending beyond sun-exposed areas: In some cases, the redness and inflammation may spread to areas not directly exposed to sunlight [8].

It's essential to note that these symptoms can appear similar to other skin conditions, such as eczema or contact dermatitis. If you suspect you have ketoprofen photoallergic dermatitis, consult a healthcare professional for proper diagnosis and treatment.

References:

[1] T Nihira (2019) - Erythema accompanied by small blisters and exudate in a rectangular area on both feet, corresponding to the shape of the compresses. Drug-...

[7] Severe pruritus is often associated... Rare features of PACD include systemic reactions, such as fever, rigors, diarrhea, and liver dysfunction. Erythema...

[8] J Kowalska (2021) - Clinical manifestations of photoallergy to ketoprofen include erythema, edema, and papulovesicular, extending beyond the areas of drug and sun exposure [87].

Diagnostic Procedures for Ketoprofen Photoallergic Dermatitis

Ketoprofen-induced photoallergic dermatitis can be diagnosed through various diagnostic tests, including:

• Photopatch testing: This is a crucial test that confirms the diagnosis of photoallergic contact dermatitis. The suspected allergen (ketoprofen) is applied to the back in 2 sets, and the skin is then exposed to ultraviolet A (UVA) light for 24 hours [7]. If a reaction occurs, it indicates an allergy to ketoprofen.
• Drug photoprovocation tests: This test is used to confirm the diagnosis of photoallergic contact dermatitis. It involves applying the suspected allergen (ketoprofen) to the skin and then exposing it to UVA light [4].
• Patch testing with the baseline series: In some cases, patients may be patch tested with a baseline series as part of the investigative procedure. This can help identify other potential allergens that may be contributing to the dermatitis [5].

Interpretation of Results

It's essential to note that false negative or delayed reactions may occur due to ketoprofen's anti-inflammatory properties [13]. Therefore, it's recommended to postpone reading the patch test until 5-7 days after administration [18].

These diagnostic tests can help confirm the diagnosis of ketoprofen-induced photoallergic dermatitis and guide treatment decisions.

References

[4] Oct 22, 2024 — Ketoprofen‐induced photoallergic consort contact dermatitis: A ... diagnostic procedures (photopatch and drug photoprovocation tests). [5] by V Marmgren · Cited by 2 — Of the 94 patients with photoallergy to ketoprofen, 90 were patch tested with the baseline series as a part of the investigative procedure. [7] The standard procedure for photopatch testing includes. 24-h occlusion of the allergen, followed by irradiation at. 5 J/cm2 ultraviolet A (UVA). [13] Treatment of ketoprofen-induced photoallergic dermatitis includes discontinuation of ketoprofen, topical or systemic corticosteroids and avoidance of sun exposure and agents known to exacerbate dermatitis. ... If ketoprofen-induced photoallergic dermatitis is suspected, photo-patch testing can confirm the diagnosis. Of note, as ketoprofen has anti-inflammatory properties, false negative or delayed reactions may occur 18. Therefore, postponing the reading of the patch test until 5-7 days after administration has also been suggested 30.

Treatment Options for Ketoprofen Photoallergic Dermatitis

Ketoprofen-induced photoallergic dermatitis can be effectively managed with the following treatment options:

• Discontinuation of Ketoprofen: Stopping the use of ketoprofen is essential to prevent further skin reactions.
• Topical Corticosteroids: Applying topical corticosteroids can help reduce inflammation and alleviate symptoms.
• Systemic Corticosteroids: In severe cases, systemic corticosteroids may be prescribed to control the reaction.
• Avoidance of Sun Exposure: Patients should avoid exposure to sunlight or use protective measures such as clothing, hats, and sunscreen with a high SPF to prevent further skin reactions.

It is also recommended that patients with ketoprofen photoallergy avoid using certain medications that have a similar biochemical structure, including:

• Some NSAIDs (suprofen, tiaprofenic acid)
• Antilipidemic agent (fenofibrate)
• Sunscreens based on benzophenones (6,9)

By following these treatment options and taking preventive measures, patients can effectively manage ketoprofen-induced photoallergic dermatitis.

References:

• [14] Treatment of ketoprofen-induced photoallergic dermatitis includes discontinuation of ketoprofen, topical or systemic corticosteroids and avoidance of sun exposure and agents known to exacerbate dermatitis.
• [15] Due to their similar biochemical structure, patients with ketoprofen photoallergy should avoid using some drugs such as some NSAIDs (suprofen, tiaprofenic acid), antilipidemic agent (fenofibrate) and sunscreens based on benzophenones (6,9).

Ketoprofen-induced photosensitivity reactions can be challenging to diagnose, as they may present similarly to other skin conditions. However, understanding the key characteristics and clinical course of ketoprofen-induced photosensitivity is essential for accurate diagnosis and management.

Differential Diagnoses:

• Allergic Contact Dermatitis: This condition presents with an itchy, red rash on the skin, often accompanied by blistering or crusting. While similar to ketoprofen-induced photosensitivity, allergic contact dermatitis typically occurs without exposure to sunlight.
• Drug Eruptions: These are adverse reactions to medications, which can manifest as a range of symptoms, including rashes, blisters, and other skin lesions. Drug eruptions may be triggered by various factors, including genetic predisposition and environmental influences.
• Epidermolysis Bullosa: This is a rare genetic disorder characterized by the formation of blisters on the skin and mucous membranes. While epidermolysis bullosa can present with similar symptoms to ketoprofen-induced photosensitivity, it typically involves more severe blistering and may be accompanied by other systemic complications.
• Irritant Contact Dermatitis: This condition occurs when the skin comes into contact with an irritating substance, leading to redness, swelling, and sometimes blistering. Irritant contact dermatitis is often caused by exposure to chemicals, detergents, or other substances that can damage the skin.

Key Diagnostic Features:

• Photoallergic Dermatitis: This condition presents as a cell-mediated immune process, typically triggered by exposure to sunlight.
• Sharp Demarcation: Ketoprofen-induced photosensitivity often presents with sharply demarcated eczematous lesions on the affected area.
• Eczematous Lesions: These are characteristic skin lesions that appear as red, itchy patches or blisters.

Clinical Course:

• Cell-Mediated Immune Process: Ketoprofen-induced photosensitivity is a cell-mediated immune process, which means that the body's immune system plays a key role in triggering and maintaining the condition.
• Delayed-Type Hypersensitivity: This type of hypersensitivity reaction occurs when the immune system takes time to respond to an allergen or irritant.

Management:

• Avoiding Exposure: The most effective way to manage ketoprofen-induced photosensitivity is to avoid exposure to sunlight and other potential triggers.
• Topical Treatments: Topical corticosteroids, moisturizers, and other treatments may be used to alleviate symptoms and promote healing.

References:

1. [4] Ketoprofen-induced photosensitivity reactions usually present as photoallergic dermatitis, which is a cell-mediated immune process.
2. [8] An understanding of the presentation and clinical course of ketoprofen-induced photosensitivity is necessary to correctly diagnose and manage this condition.
3. [9] Photoallergic contact dermatitis from ketoprofen presenting as sharply demarcated eczematous lesions on the leg.

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