J Invest Dermatol. 1989 Aug;93(2):201-9. doi: 10.1111/1523-1747.ep12277571.

Photosensitivity and hyperpigmentation in amiodarone-treated patients: incidence, time course, and recovery.

The Journal of investigative dermatology

K Rappersberger, H Hönigsmann, B Ortel, A Tanew, K Konrad, K Wolff

PMID: 2754275 DOI: 10.1111/1523-1747.ep12277571
Free Article

Abstract

Amiodarone (AD) induces photosensitivity in 75% of the patients treated with this drug. Phototoxic reactions can be experimentally elicited with UVA but not with UVB. The UVA-MED is significantly reduced after 12 months of treatment. The development of photosensitivity depends on the total dose of AD; 40 g is the minimal cumulative dose requirement. Under the regimens commonly used, photosensitivity can be expected after 4 months of continuous AD treatment and appears to be unrelated to the skin type. Photosensitivity gradually decreases and returns to normal between 4 and 12 months after the withdrawal of AD. AD-related hyperpigmentation develops after an average of 20 months of continuous AD treatment and a minimal total dose of 160 g AD in about 8% of the patients (mainly of skin type I). Electron microscopic examination of the sun-exposed skin of patients without AD discoloration shows pigment deposits similar to those already described in patients with AD hyperpigmentation in exposed and non-exposed skin. Light and electronmicroscopic examination of sun-exposed skin of both clinically photosensitive and non-photosensitive patients reveals perivascular inflammation even in the absence of a clinical rash. Reduplications of vascular basal laminae occur in sun-exposed skin of both patients with and without UVA photosensitivity but are absent from non-exposed skin. In one patient, followed for 33 months after drug withdrawal, massive AD-induced hyperpigmentation was found to be reversible.

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Substances

• Amiodarone

MeSH terms

• Amiodarone / adverse effects
• Face
• Humans
• Microscopy, Electron
• Photosensitivity Disorders / chemically induced
• Photosensitivity Disorders / pathology
• Pigmentation Disorders / chemically induced
• Pigmentation Disorders / pathology
• Radiation Injuries
• Skin / pathology
• Skin / ultrastructure
• Sunlight / adverse effects
• Time Factors
• Ultraviolet Rays / adverse effects

Publication Types

• Journal Article
• Research Support, Non-U.S. Gov't

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