Phototoxic reactions aminolevulinic acid

St. John s wort 5-Aminolevulinic acid A phototoxic reaction occurred in a patient... 

An isolated case report describes a severe phototoxic reaction attributed to a synergistic effect of S-aminolevulinic acid and St John s wort. 

Skin Photodynamic therapy causes selective destruction of abnormal cells by activating a photosensitizer in the presence of oxygen. Local phototoxic reactions and pain are the most common limiting adverse reactions. In a randomized comparison in healthy volimteers of the local phototoxic response to photodynamic therapy with 5-aminolevulinic acid 20% or methylaminolevulinate 160 mg/g cream, pain, detection of substance P, change in fluorescence intensity from before to 5 hours after cream application, and adverse reactions not related to local phototoxicity were studied [57 ]. Aminolevulinic acid and methylaminolevulinate caused equivalent frequencies of local adverse reactions, except for a higher frequency and extent of hyperpigmentation after exposure to aminolevulinic acid for 28 days. 

Steinbauer J, Schreml S, Karrer S, Ackermann G, Babilas P, Landthaler M, Szeimies RM. Phototoxic reactions in healthy volunteers following photodynamic therapy with methylaminolevulinate cream or with cream containing 5-aminolevulinic acid a phase II, randomized study. Photo-dermatol Photoimmunol Photomed 2009 25(5) 270-5. 

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