Skin photosensitivity amiodarone

Photosensitivity Amiodarone has induced photosensitization in about 10% of patients. During long-term treatment, a blue-gray discoloration of the exposed skin may occur some protection may be afforded by sun barrier creams or protective clothing. This is slowly and occasionally incompletely reversible on discontinuation of drug. 

Skin Skin photosensitivity and blue-grey pigmentation are rarely seen adverse effects of amiodarone which are mainly reported in elderly patients [18]. 

Amiodarone IV Hypotension, sinus bradycardia Oral Blue-grey skin discoloration, photosensitivity, corneal microdeposits, pulmonary fibrosis, hepatotoxicity, sinus bradycardia, hypo- or hyperthyroidism, AV block... 

Amiodarone Tremor, ataxia, pareslfresia, insomnia, corneal microdeposits, optic neuropathy/neuritis, nausea, vomiting, anorexia, constipation, TdP (<1%), bradycardia or AV block (IV and oral use), pulmonary fibrosis, liver function test abnormalities, hepatitis, hypothyroidism, hyperthyroidism, photosensitivity, bluegray skin discoloration, hypotension (IV use), phlebitis (IV use)... 

Photosensitization occurs in 10% of patients. With continued treatment, the skin assumes a blue-gray coloration. The risk is increased in patients of fair complexion. The discoloration of the skin regresses slowly, if at all, after discontinuation of amiodarone. 

Adverse effects Amiodarone shows a variety of toxic effects. After long-term use, more than one half of the patients receiving the drug show side effects sufficiently severe to prompt its discontinuation. Some of the more common effects include interstitial pulmonary fibrosis, gastrointestinal tract intolerance, tremor, ataxia, dizziness, hyper- or hypothyroidism, liver toxicity, photosensitivity, neuropathy, muscle weakness, and blue skin discoloration caused by iodine accumulation in the skin. As noted earlier (see p. 166) recent clinical trials have shown that amiodarone did not reduce incidence of sudden death or prolong survival in patient with congestive heart failure (CHF). 

AMIODARONE CYTOTOXICS t risk of photosensitivity reactions Attributed to additive effects Avoid exposure of skin and eyes to direct sunlight for 30 days after porfimer therapy... 

PORFIMER I. ACE INHIBITORS -enalapril 2. ANALGESICS -celecoxib, ibuprofen, ketoprofen, naproxen 3. ANTIARRHYTHMICS — amiodarone 4. ANTIBIOTICS -ciprofloxacin, dapsone, sulphonamides, tetracyclines 5. ANTICANCER AND IMMUNOMODULATING DRUGS -fluorouracil (topical and oral) 6. ANTIDIABETIC DRUGS-glipizide 7. ANTIMALARIALS -hydroxychloroquine, quinine 8. ANTIPSYCHOTICS -chlorpromazine, fluphenazine 9. CALCIUM CHANNEL BLOCKERS - diltiazem 10. DIURETICS -bumetanide, furosemide, hydrochlorothiazide II. PARA-AMINOBENZOIC ACID (TOPICAL) 12. RETINOIDS-acitretin, isotretinoin 13. SALICYLATES (TOPICAL) t risk of photosensitivity reactions Attributed to additive effects Avoid exposure of skin and eyes to direct sunlight for 30 days after porfimer therapy... 

Amiodarone commonly causes phototoxicity reactions (186,187). The risk of phototoxicity increases with the duration of the exposure. Window glass and sun screens do not give protection, although zinc or titanium oxide formulations and narrow band UVB photo therapy can help (188-190). For most patients this adverse effect will be no more than a nuisance, and the benefit of therapy may be worthwhile. However, in a few cases treatment may have to be withdrawn. Histological examination of skin biopsies shows intracytoplasmic inclusions of phospholipids (191). There has been a single report of a severe case of photosensitivity in conjunction with a syndrome resembling porphyria cutanea tarda, resulting in bullous lesions (192). 

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