Allergy Asthma Respir Dis.  2017 Nov;5(6):358-360. 10.4168/aard.2017.5.6.358.

Photosensitivity caused by dronedarone: A case report

• Lee JH
• Kim SM
• Jung CG
• Park HS
• Shin YS

• KMID: 2396678
• DOI: http://doi.org/10.4168/aard.2017.5.6.358

Abstract

Dronedarone is a new antiarrhythmic drug for the treatment of nonpermanent atrial fibrillation. Compared with amiodarone, it is regarded as a safe medication due to its structural differences. In this report, we describe a 56-year-old man who developed photosensitivity due to dronedarone. He presented with itchy skin rashes for 1 week. Maculopapular exanthema was localized on the neck, both arms, and both hands, with sparing of the other parts of the body. Dronedarone was prescribed 4 weeks ago when atrial fibrillation occurred. After development of skin rashes, dronedarone was discontinued, and systemic steroid, antihistamine, and topical corticosteroid were administered for 1 week, with improvement in skin rashes. The photopatch test was performed with antiarrhythmic drugs, including dronedarone, amiodarone, and flecainide, 4 weeks after withdrawal of dronedarone. Positive reactions were recorded only to dronedarone at the site exposed to ultraviolet A. He was diagnosed with dronedarone-induced photosensitivity and advised to change the antiarrhythmic medication to others. There have been a few case reports on photosensitivity reactions due to dronedarone, which were diagnosed only by clinical suspicion. However, we suspected photosensitivity and proved it by the photopatch test. Photosensitivity should be considered in patients having skin rashes on the exposed area and taking antiarrhythmic medication, including dronedarone.

Keyword

Dronedarone; Photosensitivity; Photopatch test

MeSH Terms

Amiodarone
Anti-Arrhythmia Agents
Arm
Atrial Fibrillation
Exanthema
Flecainide
Hand
Humans
Middle Aged
Neck
Amiodarone
Anti-Arrhythmia Agents
Flecainide

Figure

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  Fig. 1. Chemical structure of dronedarone (A) and amiodarone (B).

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  Fig. 2. Maculopapular eruptions on the upper body with a photodistributed pattern (A), localized in the forearm and the dorsal area of the hand (B), and the neck with V-neck sign (C) at presentation.

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  Fig. 3. Photopatch test results on day 4 showing an erythematous change (1+) with ultraviolet (UVA) (A), and a negative response at the nonirradiated control site (B). 1, dronedarone; 2, amiodarone; 3, flecainide.

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