Generic selectors
Exact matches only
Search in title
Search in content
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Retraction
Review
Review Article
Review Articles
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Special Article
Specialty Interface
Studies
Study Letter
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Tables
Technology
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
View Point
Viewpoint
What’s new in Dermatology
Case Report
2002:68:4;240-241
PMID: 17656954

Glibenclamide induced photosensitivity

Archana Singal, SN Bhattacharya, MC Baruah
 Department of Dermatology and STD, University College of Medical Sciences and Guru Teg Bahadur Hospital Shadara, Delhi - 110 095, India

Correspondence Address:
Archana Singal
B-16, F-I, Dilshad Garden, Delhi - 110 095
India
How to cite this article:
Singal A, Bhattacharya S N, Baruah M C. Glibenclamide induced photosensitivity. Indian J Dermatol Venereol Leprol 2002;68:240-241
Copyright: (C)2002 Indian Journal of Dermatology, Venereology, and Leprology

Abstract

A 54 - year-old man with diabetes mellitus developed photodermatitis following ingestion of second generation sulphonylurea, glibenclamide. The case is being reported to highlight the infrequently reported side effect of glibenclamide.
Keywords: Photosensitivity, Diabetes, Glibenclamide, Sulphonylurea

Introduction

Photosensitization is defined as a process by which a reaction is induced to an otherwise innocuous amount of radiation by the introduction of a specific radiation absorbing substance, the photosensitizer, that causes another component, the substrate, to be changed by the radiation.[1] Drugs constitute a major group of cutaneous photosensitizers. Drugs commonly implicated are antimicrobials (tetracyclines, sulfonamides, quinolones) oral hypoglycemics, thiazides, phenothiazines, NSAIDS, antiarrythmics (quinidines, amiodarones), methyldopa, and griseofulvin. Here we report a case of photosensitive dermatitis caused by glibenclamide, a commonly used antihypoglycemic agent, because of its uncommon occurrence.

Case Report

A 54- year - old -man presented with recurrent furunculosis of three months duration. On investigation he was found to have a random blood sugar level of 342 mg/dl. He was referred to endocrinology outpatient department for management of diabetes. Initially the patient was prescribed tablet glibenclamide 5 mg daily along with dietary advice. Four weeks later his dosage of glibenclamide was increased to 5 mg thrice a day for more effective control of diabetes. About five months later the patient began to experience unpleasant burning and itching sensation following sun exposure. This photosensitivity progressively worsened, and over a month he developed extremely pruritic, eczematous lesions on face; neck; extensor aspects of forearms; dorsa of hands and feet; as well as bald areas of scalp. Sun protected areas such as periorbital; retroauricular and submental areas were characteristically spared. On clinical suspicion of glibenclamide induced photodermatitis the drug was withdrawn and a structurally dissimilar biguanide derivative, metformin, in a dosage of 0.5mg twice daily was prescribed in conjunction with strict diet control achieving adequate control of hyperglycemia. To hasten relief from photodermatitis he was also prescribed topical clobetasol proprionate (0.05%) cream along with tabletcetrizine 10 mg once daily. The patient was advised protective clothing. His skin condition rapidly improved with clinical remission over three weeks.Three months later photodermatitis again relapsed because he was restarted on glibenclamide by his local physician due to temporary non-availability of metformin and with the assumption that photosensitivity was a one time phenomenon. He responded again to withdrawal of glibenclamide, which was substituted with metformin.

Discussion

Oral hypoglycemic agents particularly first generation sulfonylureas (tolbutamide, chlorpropamide) are well known photosensitizers. Patients developing photosensitivity to these drugs usually have had a cumulative dose varying from 10-50 grams (daily dosages varying from 100500 mg of chlorpropamide and 1-3 grams of tolbutamide), over periods ranging from three weeks to four years. The second generation sulfonylueas (glibenclamide, gliburide and glipizide) are reported less frequently as photosensitizers. This may partly be clue to the fact that their higher potency results in prescription of smaller amounts of drug (glibenclamide is prescribed in daily dosages of 2.5 mg to 20 mg). However in two reported cases photosensitivity occurred at lower cumulative dosages (1.8-3.6 grams over 61/12 to 8 months) as compared to the first generation sulfonylurea.[2] In another diabetic with associated erythropoietic protoporphyria; photosensitization occurred at even lower cumulative dosage of about 0.45 gram.[3] Our patient developed photosensitivity at a total cumulative dosage of 1.8 gram. A detailed reevaluation including history of occupational and enviromental exposure to potential photosensitizers was unrewarding and biochemical analysis of serum and urine was otherwise within normal limits. This case is being reported, to illustrate an infrequently reported side effect of the second generation sulphonylureas that might easily be missed or attributed to another cause.

References
1.
Gonza lez E, Gonzalez S. Drug photosensitivity, idiopathic photodermatoses and sunscreens. J Am Acad Dermatol 1996;35:871-885.
[Google Scholar]
2.
Chee Ching S. Photosensitivity due to glyburide. Photodermatology 1988;5:42-44.
[Google Scholar]
3.
Fujii S, Nakashima T, Kaneko T. Glibenclamide induced photosensitivity in a diabetic patient with erythropoietic protoporphyria. Am J Hematol 1995;50:223.
[Google Scholar]
Show Sections