In this Image in Clinical Medicine from the New England Journal of Medicine, a painful red rash is seen on the hands of a teenager who had recently started oral doxycycline.
The authors describe an adolescent who presented with a worsening erythematous, painful, blistering rash on both hands. The rash was sharply demarcated and looked like a sunburn. It began 1 week after starting oral doxycycline for acne treatment.
The patient’s history of taking an antibiotic known to cause photosensitivity — and the absence of alternative explanations such as autoimmune disease — is a strong clue for drug-induced phototoxicity. Clinicians should know that the rash on sun-exposed areas can develop within days of starting a phototoxic drug like doxycycline and is dose-dependent. This rash, on a patient with light skin color, can look like a sunburn, but on patients with darker skin it can present differently. Regardless…
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The authors describe an adolescent who presented with a worsening erythematous, painful, blistering rash on both hands. The rash was sharply demarcated and looked like a sunburn. It began 1 week after starting oral doxycycline for acne treatment.
The patient’s history of taking an antibiotic known to cause photosensitivity — and the absence of alternative explanations such as autoimmune disease — is a strong clue for drug-induced phototoxicity. Clinicians should know that the rash on sun-exposed areas can develop within days of starting a phototoxic drug like doxycycline and is dose-dependent. This rash, on a patient with light skin color, can look like a sunburn, but on patients with darker skin it can present differently. Regardless…