A Case of Photo-onycholysis induced by Doxycycline
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Abstract
Photo onycholysis, characterized by the separation of the nail plate from the nail bed after exposure to ultraviolet (UV) light, is a rare photosensitivity reaction. This condition may involve one or more nails and typically presents with pain in the nail bed or tips of the fingers and toes, progressing to subungual erythema, subungual hemorrhage, and onycholysis. Various medications, including tetracyclines, psoralens, chloramphenicol, non-steroidal anti-inflammatory drugs (NSAIDs), fluoroquinolones, and doxycycline, have been implicated in inducing this phototoxic reaction. Given a therapeutic dose of an inducing drug and ample light irradiation, any patient is susceptible to developing phototoxic reactions. Although complete avoidance of these drugs is unnecessary, precautions should be taken. We report a case of a 21-year-old military personnel who exhibited distal onycholysis of the fingernails lasting for 1 month following a 2-week course of doxycycline usage. Based on history, physical examination, and laboratory investigation, the patient was diagnosed with doxycycline-induced photo-onycholysis.
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