Insights into proton pump inhibitor-induced photosensitivity: An observational study in a tertiary photobiology service

Abstract

Background: Proton pump inhibitors (PPIs) are extensively prescribed but may cause photosensitivity and drug-induced lupus erythematosus (DILE), which can be overlooked as the drug may have been taken for years prior to presentation. Methods: We reviewed the clinical and investigation findings of patients diagnosed with PPI-induced photosensitivity, diagnosed through the Scottish Photobiology Service. Results: We report 11 patients with median age of onset 61-years and mean duration of PPI ingestion of 5-years [DILE ( n = 6), phototoxicity ( n = 3) and drug-induced solar urticaria through a lupus mechanism ( n = 2)]. Five had Anti-Ro antibodies (three also ANA positive). Predominantly UVA and visible light photosensitivity was observed on phototesting. Discussion: PPIs are a reversible cause of photosensitivity and DILE. Time to onset from drug initiation to symptoms can be prolonged, so clinicians should have a high index of suspicion in those taking PPIs. Most are diagnosed through clinical assessment and lupus serology, with phototesting indicated if there is diagnostic uncertainty.