Quinolone photoallergy: photosensitivity dermatitis induced by systemic administration of photohaptenic drugs.

Quinolone antibacterial agents are well known to elicit photosensitivity as a side effect. The photoallergenicity of fluoroquinolones, the representative quinolone derivatives, is mainly derived from their photohaptenic moiety. When epidermal cells are irradiated with ultraviolet A light in the presence of fluoroquinolones, quinolone photoadducts are formed in the treated cells. This photomodification is thought to be an initial step for sensitization and elicitation of this photoallergy, and quinolone-photoderivatized Langerhans cells are capable of stimulating immune T cells in mice. In the murine model, fluoroquinolone photoallergy is mediated by Th1 cells bearing T cell receptor Vbeta 13. There is a broad photoantigenic cross-reactivity among fluoroquinolones in recognition by T cells and immunoglobulins. Therefore, it is most likely that fluoroquinolones carry the same photoantigenic epitope, which is recognized by Vbetal3+ T cells, leading to fluoroquinolone photosensitivity and cross-reactivity.