By vgreene, 25 January, 2018
By vgreene, 25 January, 2018
By vgreene, 25 January, 2018
By vgreene, 25 January, 2018
(BMJ)—A 64-year-old man with recent history of septic arthritis treated with fusidic acid and doxycycline x7 days presented with a severe blistering rash that appeared 4h after arriving at a beach vacation in Spain. Exam: red, blistering eruption on face, neck, forearms, lower legs. What's the dx?
Drug-related photosensitivity reaction
Cutaneous lupus erythematosus
Keratoderma blennorrhagica
Hydroa vacciniforme
Stevens-Johnson syndrome
You are correct. Doxycycline is a tetracycline antibiotic that can induce a severe photosensitivity reaction upon sunlight exposure. This pt required hospital admission, but after topical tx and analgesia, he made a full recovery. Clinicians prescribing doxycycline are reminded to advise pts to avoid direct sun exposure and sunbathing.

BMJ 2017;359:j4338