We report a case of phototoxic dermatitis that spared lepromatous skin lesions with photo-onycholysis probably induced by SPFX.
Photo-onycholysis induced by SPFX is often distal, half-moon shaped, and surrounded by pigmentation.
(3) because that patient was an Indian male with Fitzpatrick Type V skin and photodermatitis with photo-onycholysis was observed in both cases, but our patient's lepromatous skin lesions were characteristically spared whereas Mahajan et al.'s patient suffered from pulmonary tuberculosis and did not exhibit such a phenomenon.
SPFX-induced photosensitivity and photo-onycholysis should be readily recognized by dermatologists so that it can be appropriately investigated and promptly treated to avoid serious sequelae such as lichenoid reaction, which is very difficult to treat.
Drug-induced photo-onycholysis. Three subtypes identified in a study of 15 cases.
(9.) Logan RA, Hawk JL Spontaneous photo-onycholysis. Br J Dermatol.
Photo-onycholysis is a rare phototoxic reaction, which occurs due to the separation of the nail plate from the nail bed after a drug ingestion and exposure to ultraviolet (UV) light.
The final diagnosis was drug-induced (diclofenac) photo-onycholysis. The patient was treated symptomatically.
Photo-onycholysis can occur due to loss of nail bed-plate adhesion because of damage to the nail bed epithelium with epidermolysis and/or with formation of hemorrhagic bulla.
Photo-onycholysis is usually drug-induced, but it might occur in some photosensitivity disorders such as porphyria.
The most frequently cited drugs that cause photo-onycholysis are tetracyclines, psoralens, and fluoroquinolones.
For example, antineoplastic drugs may cause onycholysis, and sun exposure during tetracycline therapy may cause photo-onycholysis
. Retinoids may cause nail brittleness.