+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Solar burn reactivation induced by methotrexate

, : Solar burn reactivation induced by methotrexate. PharmacoTherapy 30(4): 123e-126e

Solar burn reactivation, a rare and idiosyncratic drug reaction, has been reported with the use of a variety of drugs. This reaction is believed to be the result of exposure to ultraviolet light during the subsiding phase of an acute inflammatory reaction. It affects areas of the body that have been previously sunburned. We describe a 16-year-old girl who was receiving treatment for acute lymphoblastic leukemia and experienced a second-degree solar burn reactivation reaction to methotrexate. The patient had a mild sunburn on her face and shoulders the day she went to the oncology clinic for her interim maintenance chemotherapy with vincristine 1.5 mg/m(2)/dose and methotrexate 100 mg/m(2)/dose. Three days later, she returned to the clinic with a 2-day history of fever (<or= 100.2 degrees F), nausea, vomiting, and malaise; the sunburn on her face and shoulders also had become severe, without further sun exposure. Laboratory results revealed elevated blood urea nitrogen and serum creatinine concentrations, and her methotrexate level was elevated at 0.9 mM. The patient was diagnosed with acute renal failure, dehydration, methotrexate toxicity, and second-degree solar burn reactivation reaction. She was admitted to the children's hospital and treated with sodium bicarbonate, acetaminophen with codeine, ondansetron, and silvadene cream. On hospital day 3, the patient's methotrexate level decreased to less than 0.1 mM. The sunburn continued to heal, and after a 14-day hospital stay, complicated by a streptococcal infection, grade 3 mucositis, bacteremia, and mild gastritis and duodenitis, the patient recovered and was discharged. Use of the Naranjo adverse drug reaction probability scale indicated a probable relationship (score of 6) between the patient's solar burn reactivation and methotrexate. Although methotrexate-induced solar burn reactivation is rare, clinicians should be aware of this potential adverse reaction and consider delaying administration of methotrexate by 5-7 days if a patient reports ultraviolet-related erythema in the past 2-4 days or presents with a notable sunburn.


PMID: 20334462

DOI: 10.1592/phco.30.4.419

Other references

Heyen, C.A.; Delk, P.R.; Bull, M.J.; Weaver, D.D., 2008: A report of an apparent new genetic syndrome consisting of joint contractures, keloids, large optic cup-to-disc ratio and renal stones. We report on a family with an apparently undescribed syndrome involving joint contractures, keloids, an increased optic cup-to-disc ratio, and renal stones. The propositus presented at 9 years of age with congenital contractures of his distal inte...

Linsley Robert M., 1982: Reconstructing ancient gastropods. Journal of Paleontology: uppl. to No. 2.; Pages 16-17. 1982.

Brouty-Boyé, D.; Wybier-Franqui, J.; Calvo, C.; Feunteun, J.; Gresser, I., 1984: Reversibility of the transformed and neoplastic phenotype. IV. Effects of long-term interferon treatment of C3H/10T1/2 cells transformed by methylcholanthrene and SV40 virus. The effects of long-term treatment with mouse interferon on the phenotype of untransformed C3H/10T1/2 cells and cloned derivatives transformed by methylcholanthrene (MCA) and Simian virus 40 (SV40) were investigated. Continuous presence of interfe...

Ingraham L.L., 1969: The electronic spectra of the isomers of reduced 1 alkyl nicotinamide nuclear magnetic resonance. Archives Of Biochemistry & Biophysics: 352-358

Mika Peck; Ana Mariscal; Martin Padbury; Tim Cane; Dominic Kniveton; Miguel Angel Chinchero, 2012: Identifying tropical Ecuadorian Andean trees from inter-crown pixel distributions in hyperspatial aerial imagery. Identification of tropical tree species from low-cost, very high-resolution (VHR) proximal canopy remote sensing imagery has great potential for improving our understanding of tropical forest ecology. We investigated whether inter-crown pixel info...

Williams, R.D., 1966: Partial and intermittent biliary tract obstruction. Response of serum bilirubin and alkaline phosphatase in dogs. American Surgeon 32(7): 479-482

Reagan, J.W., 1950: The ovarian Brenner tumor; its gross and microscopic pathology. American Journal of Obstetrics and Gynecology 60(6): 1315-1323

Hughes, E.B.C., 2010: Indirect injury of the optic chiasma; a case report. British Journal of Ophthalmology 29: 629-631

O'gara, P.J., 1915: A New Disease Of Germinating Wheat. Science 42(1079): 313-314

Shoemaker, W.C., 1971: Physiologic mechanisms in clinical shock. Advances in Experimental Medicine and Biology 23(0): 57-75