Abstract

Background: Photosensitization is a cutaneous reaction that occurs following exposure to sunlight. It may present as phototoxicity or as photoallergy, an immunologically mediated reaction.

The aim of this study was 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 study over an 11-year period, including all cases of drug-induced photosensitivity reported to the National Pharmacovigilance Center (CNPV).

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 hours 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 extending 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 repeated photosensitization may increase the long-term risk of photocarcinogenesis, underscoring the need for vigilance during high-risk treatments.