Frågedatum: 1998-02-01
RELIS database 1998; id.nr. 14270, DRUGLINE
www.svelic.se
Utredningen som riktar sig till hälso- och sjukvårdspersonal, har utformats utefter tillgänglig litteratur och resurser vid tidpunkten för utredning. Innehållet i utredningen uppdateras inte. Hälso- och sjukvårdspersonal är ansvarig för hur de använder informationen vid rådgivning eller behandling av patienter.


Is photosensitivity a known side effect of folic acid, vitamin B12, vitamin B6 or betaine?/nA 21-ye



Fråga: Is photosensitivity a known side effect of folic acid, vitamin B12, vitamin B6 or betaine?

A 21-year-old woman with methylenetetrahydrofolate reductase deficiency is treated with folic acid 5 mg twice daily, vitamin B12 one tablet once daily, vitamin B6 300 mg daily and betaine 7 gram daily since three years with good clinical effect. The methionine levels have normalised and the homocysteine concentration is lower than before treatment.

She went on vacation and after one day in the sun she reacted with heavy skin reaction, pain and edema in the lower parts of her legs and she was admitted to the hospital. Could these symptoms be caused by her treatment?

Sammanfattning: Dermal side effects are known but are rare side effects to all the above mentioned drugs. Photosensitivity has been reported in a few cases in connection to treatment with vitamin B6.

Svar: A few case reports of photosensitivity due to treatment with vitamin B6 are described in the literature, in all these cases the reactions were reversible on withdrawal (2-5). Other reactions were contact dermatitis, subepidermal vesicular eruptions and sensory peripheral neuropathy (2-7). The incidence of photosensitivity is hard to evaluate since vitamin B6 is an over the counter drug (7).

A thorough literature search including Medline, Drugline and common pharmacological handbooks, has not revealed any case reports concerning photosensitivity induced by vitamin B12, folic acid or betaine. However a few cases of other skin reactions have been found.

Urticaria and acneiform eruptions are known but rare side effects of vitamin B12 treatment (8-13). Seventeen cases of dermal side effects induced by vitamin B12 have been reported to SADRAC including cases of urticaria, exanthema, and edema (13). All skin reactions, described in the literature, except one occurred within the first two months of treatment, usually within days (14).

Contact dermatitis is described for betaine when it is used in various cosmetics (15).

Hypersensitivity due to folic acid has been reported in one case (16).

Since the dechallenge was positive we recommend this case be reported to SADRAC (The Swedish Adverse Reactions Advisory Committee).

Referenser: