Doxycycline Phototoxicity in a Traveler

A report describes a case of a 16-year-old girl who presented with erythema on the dorsal aspect of her hands. She reported recent travel history to Peru for three weeks, where the erythema initially started. She documented taking doxycycline, 100 mg twice daily, for her acne, throughout her trip as her malaria prophylaxis. 

Physical examination showed erythematous patches with vesicles over the dorsal aspect of the first and second digits of both hands. Upon further investigation, it was discovered that during a hiking trip in Peru, the patient had used hiking poles that caused the affected areas to be directly exposed to intense sunlight. On the completion of malaria prophylaxis, doxycycline was discontinued, and amoxicillin was prescribed for acne, which eventually resolved the rash.

Paradkar KA, Wolf M, Mosser-Goldfarb J. Doxycycline Phototoxicity: A Cautionary Tale for Travelers. The Journal of Pediatrics. 2021:243-245. DOI:https://doi.org/10.1016/j.jpeds.2021.12.031