Sparfloxacin-induced photosensitivity and the occurrence of a lichenoid tissue reaction after prolonged exposure.
BACKGROUND
A new antibacterial quinolone, sparfloxacin (SPFX), frequently causes photosensitive dermatitis and sometimes induces a treatment-resistant lichenoid tissue reaction (LTR).


OBJECTIVE
We attempted to determine the factors that induce LTR in SPFX-induced photodermatitis.


METHODS
Thirteen patients with SPFX photosensitive dermatitis were studied clinically and histopathologically.


RESULTS
Six of the 13 patients had acute dermatitis with epidermal spongiosis and focal epidermal HLA-DR and intercellular adhesion molecule-1 (ICAM-1) expression with CD4+ cell infiltration. The other seven displayed LTR with basal cell liquefaction degeneration and diffuse epidermal HLA-DR and ICAM-1 expression associated with CD8+ cells. The seven patients with LTR were exposed to UV and SPFX for more than 2 weeks after the appearance of their initial eruption, whereas the six patients with acute dermatitis were treated within 2 weeks. The acute dermatitis lesions cleared significantly within 2 weeks, but the LTR lesions persisted for more than 6 weeks.


CONCLUSIONS
Patients with quinolone-induced photosensitivity should be treated within 2 weeks of onset to prevent LTR.
Hamanaka
H
H
Department of Dermatology, Mie University, Faculty of Medicine, Tsu, Japan.
Mizutani
H
H
Shimizu
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000009:adverse effects*; D003875:Drug Eruptions / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D005260:Female; D024841:Fluoroquinolones; D006684:HLA-DR Antigens / Q000032:analysis; D006801:Humans; D007150:Immunohistochemistry; D018799:Intercellular Adhesion Molecule-1 / Q000032:analysis; D017512:Lichenoid Eruptions / Q000139:chemically induced* / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010787:Photosensitivity Disorders / Q000139:chemically induced* / Q000378:metabolism / Q000473:pathology; D015363:Quinolones / Q000009:adverse effects*; D012867:Skin / Q000378:metabolism / Q000473:pathology
D000890:Anti-Infective Agents; D024841:Fluoroquinolones; D006684:HLA-DR Antigens; D015363:Quinolones; D018799:Intercellular Adhesion Molecule-1; C061363:sparfloxacin