Ethinylestradiol
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Ethinylestradiol Photosensitivity: case report A 35-year-old woman developed systemic photosensitivity during use of a contraceptive patch, and subsequently with an oral contraceptive; both products contained ethinylestradiol [dosages not stated]. The woman had been using a ethinylestradiol/ norelgestromin [EVRA] transdermal patch for 3 years when she presented in March 2009 with a 2-week history of pruriginous papulovesicular eruptions on the lateral , posterior and V area of her neck. Topical corticosteriods and oral antihistamines were administered and her lesions resolved within days. Three more episodes occurred in April, May and June; due to the extensive nature of the last episode, phototesting and biopsies were performed. The biopsy confirmed spongiotic dermatitis and phototesting revealed a diminished minimal erythema dose for UVB (MED-UVB) of 0.15 J/cm2. The transdermal patch was discontinued and photosensitivity resolved until October 2 when another episode occurred. Three months prior, the woman had started taking oral ethinylestradiol/ drospirenone [YAZ] for contraception. The contraceptive was withdrawn due to suspicion of systemic photosensitivity. A photobiological study again revealed a diminished MED-UVB, which normalised 5 weeks after withdrawal . Photoprovocation testing was subsequently undertaken at 1, 3 and 5 hours after a double dose of ethinylestradiol/ drospirenone; MED-UVB was 0.15, 0.15 and 0.20 J/cm2, respectively. Laboratory findings revealed a positive ANA titre. She remained asymptomatic 4 months after stopping the oral contraceptive. Author comment: "Ethinyloestradiol is present in both ERVA and YAZ, and we believe that this the photosensitizer in our patient." Gomez-Bernal S, et al. Systemic photosensitivity due to a contraceptive patch. Photodermatology Photoimmunology and Photomedicine 26: 213-215, Aug 2010. Available from: URL: http://dx.doi.org/10.1111/j.1600-0781.2010.00517.x 803035888 Spain
0114-9954/10/1318-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Reactions 11 Sep 2010 No. 1318
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