[P479] Photosensitivity to multiple drugs: a case report = [P479] Photosensitivity to multiple drugs: a case report

다국어 초록 (Multilingual Abstract)

Photodermatoses are group of skin disease that caused or exacerbated by light radiation. Typically, skin lesions represent a characteristic photodistribution. As a subgroup, drug induced photosensitivity were explained by photoallergy and phototoxicity. Most cases are caused by single drug, and cases with multiple drugs are rare. We report a case of photosensitivity to more than one drug. A 67-year-old man was first seen for pruritic rash on face, V-shaped area of neck, dorsum of hands from a month ago. He had been taking nebivolol, trimetazidine, isosorbide mononitrate, aspirin, rosuvastatin-ezetimibe combination for 4 years and metformin for 3 months. On phototest, minimal erythema dose (MED) to UVA and UVB were decreased as 15J/㎠ and 150mJ/㎠ respectively. Laboratory studies showed GGT 166IU/L, anti-nuclear antibody titer 1:1280, positive anti-mitochondrial antibody and negative urine porphyrin. We suspected drug induced photosensitivity and performed phototest to identify culprit drug. Despite the absence of common chemical structure, metformin and aspirin were judged to culprit drugs by discontinuing each drug for 2 weeks and performing phototest. While continuing sun protection, culprit drugs were stopped. 3 weeks later, symptoms were notably improved. 6 weeks later, trimetazidine was discontinued, and nebivolol, isosorbide mononitrate, rosuvastatin-ezetimibe combination were changed. Lesions were improving steadily thereafter.