Photosensitizing Medications Use in Lupus Patients and Relation to Flare and Outcome

Zahran, Enas S.; Aleraqy, Wessam; El-Shebiny, Emad M.; Sweed, Eman M.; Foud, Tamer M.; Daif, Shymaa M.

doi:10.21608/ejhm.2025.437959.1859

Photosensitizing Medications Use in Lupus Patients and Relation to Flare and Outcome

Document Type : Original Article

Authors

¹ Internal Medicine, Immunology and rheumatology Department, Faculty of Medicine, Menoufia University, Menoufia Egypt

² Internal Medicine Department, Shebin El-Kom Teaching Hospital, Menoufia, Egypt

³ Clinical Pharmacology Department, Faculty of Medicine, Menoufia National University, Menoufia, Egypt

⁴ Dermatology, Andrology and sexually transmitted disease Department, Faculty of Medicine - Misr University for Science and Technology, Egypt

10.21608/ejhm.2025.437959.1859

Abstract

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease marked by a broad range of clinical manifestations with photosensitivity being a common and clinically significant feature. Drug-induced photosensitivity is a possibly preventable cause of disease flare and morbidity in SLE patients.
Aim: This study aimed to evaluate the association between the use of photosensitizing medications and disease flare, onset and clinical outcomes in patients diagnosed with SLE.
Subjects and methods: This retrospective cohort study included 120 patients diagnosed with SLE at Menoufia University Hospital, Egypt, between through the period from April 2023 to April 2024. Detailed drug histories, including the use of known photosensitizing agents, were collected. Clinical outcomes such as flare incidence, timing, and skin reactions were recorded and analyzed leveraging descriptive statistical methods.
Results: Most participants were females (84.2%) with a mean age of 41.3 years. Diuretics (53.3%), NSAIDs (46.7%), and antibiotics (45%) were the most commonly used photosensitizing medications. About 24.2% of patients experienced disease flares temporally associated with sun exposure and medication use. Only 25.8% reported using sun protection. Drug-induced photosensitive reactions included lichenoid eruptions, erythema multiforme and discoid lupus lesions. Most patients (70%) started these medications after their SLE diagnosis.
Conclusion: Photosensitizing medications significantly contribute to disease flare and adverse outcomes in SLE patients. Increased awareness, careful drug selection, and consistent sun protection measures are critical for optimizing patient care and reducing preventable complications.

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