Professional paper

https://doi.org/10.15836/ccar.2014.310

Photodistributed Hyperpigmentation Induced by Diltiazem.

Saida Rezaković ; Policlinic “Eskulap” Zagreb, Croatia
Lidija Počanić ; Dubrava Clinical Hospital, Zagreb, Croatia

Abstract

Drug-induced photosensitivity refers to the development of cutaneous disease as a result of the interaction of the drug and UVA and UVB light. These are primarily phototoxic reactions presenting in different clinical patterns. Skin hyperpigmentation presents as one of the most frequent phototoxic reactions. It has been associated with the use of certain antibiotics, antiepileptics, antihypertensive drugs as well as antidepressant medications. Recently, there have been reports suggesting association between use of diltiazem and appearance of photodistributed hyperpigmentation. This drug-induced
hyperpigmentation is usually refractory to conventional treatment options. The most important step in treatment management is withdrawal of the incriminating agent. Once hyperpigmentation has
been established, diltiazem should be discontinued and replaced with another antihypertensive agent, as it is essential for improvement and gradual resolution of the hyperpigmentation. The patient should
be reassured that with proper management, the hyperpigmentation is a reversible process, but informed that for total resolution of skin lesions it may take many months. Prevention of this cutaneous adverse drug reaction may be possible with the use of appropriate photoprotection. Consequently, for all patients on diltiazem, it is imperative to recommend a broad-spectrum sunscreen, as UVA and UVB radiation may both play a significant role in diltiazem-induced photodistributed hyperpigmentation.

Keywords

photodistributed hyperpigmentation; drug-induced hyperpigmentation; diltiazem; phototoxic reaction; photoprotection

Hrčak ID:

141144

URI

https://hrcak.srce.hr/141144

Publication date:

5.9.2014.

Article data in other languages: croatian

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