PDF(Pubmed)
Abstract：
A 75-year-old male was diagnosed with idiopathic pulmonary fibrosis and treated with pirfenidone. He presented with an erythematous thick scaly patch on his face, neck, and both hands and arms. He had a history of significant exposure to sunlight without using sunscreen. All lesions were restricted to sun-exposed areas and appeared one month ago. Histopathological examination revealed necrotic keratinocytes, epidermal spongiosis, liquefaction degeneration of the basal layer, interface dermatitis, solar elastosis, and upper dermal perivascular lympho-histiocytic infiltration. Based on clinical and histopathological findings, the skin lesion could be diagnosed as photosensitive drug eruption induced by pirfenidone. Pirfenidone was discontinued for a month, and the patient was treated with oral and topical corticosteroids. Consequently, the skin lesion almost fully cleared, leaving mild postinflammatory hyperpigmentation. Although there are many reports of photosensitivity reactions to pirfenidone, dermatologists are still not familiar with this drug. Through this case presentation, clinicians should be aware of the potential phototoxic effects of pirfenidone and provide the necessary precautionary information to patients who take pirfenidone.
摘要：
一名75岁的男性被诊断为特发性肺纤维化，并接受吡非尼酮治疗。他脸上有一个红斑厚的鳞片，脖子,还有双手和双臂.他有大量暴露在阳光下而不使用防晒霜的历史。所有病变仅限于阳光照射区域，并在一个月前出现。组织病理学检查显示坏死角质形成细胞，表皮海绵症,基底层液化变性，界面皮炎,太阳能弹性沉着症，和上真皮血管周围淋巴组织细胞浸润。根据临床和组织病理学发现，皮肤病变可诊断为吡非尼酮引起的光敏药疹。吡非尼酮停药一个月,患者接受口服和外用皮质类固醇治疗。因此,皮肤损伤几乎完全清除,留下轻度的炎症后色素沉着过度。尽管有许多关于吡非尼酮光敏反应的报道，皮肤科医生仍然不熟悉这种药物。通过这个案例介绍,临床医生应了解吡非尼酮的潜在光毒性作用,并向服用吡非尼酮的患者提供必要的预防信息.
