Drug-Induced Photosensitivity: Clinical and Etiological Study in Tunisia

Abstract

Background: Photosensitization refers to a cutaneous adverse reaction triggered by sunlight exposure. It manifests either as phototoxicity or as photoallergy, the latter representing an immune-mediated hypersensitivity reaction. This study aimed to describe the epidemiological and clinical characteristics of patients with drug-induced photosensitivity in Tunisia and to identify the implicated medications. Methods: We conducted a retrospective analysis of all cases of drug-induced photosensitivity reported to the National Pharmacovigilance Center (CNPV) over 11 years. Results: A total of 130 cases were analyzed. The median age was 58 years (range: 8–83), with a female-to-male ratio of 1.95. Time to onset of symptoms after drug intake ranged from 6 h to 20 years, with a median of 60 days. Phototoxic reactions represented 81.5% of cases, most commonly presenting as erythema (84.9%). Photoallergic reactions predominantly manifested as eczema, localized to photo-exposed areas in 18 cases, and expanded to covered regions, such as the trunk and back, in 6 cases. Clinical improvement following drug withdrawal was observed in 61.5% of patients. The most frequently implicated drug classes were cardiovascular medications (46.7%) and anti-infectives (16.9%). Conclusion: Although relatively uncommon, drug-induced photosensitivity should be promptly recognized by clinicians, as it can result in cosmetic and medical complications. Early discontinuation of the causative drug usually ensures resolution, while strict photoprotection remains essential to prevent recurrences. Importantly, chronic or recurrent photosensitization can elevate the long-term risk of photocarcinogenesis, emphasizing the need for careful monitoring and preventive measures during high-risk therapies.