{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T05:09:47Z","timestamp":1777957787128,"version":"3.51.4"},"reference-count":30,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,8,27]],"date-time":"2021-08-27T00:00:00Z","timestamp":1630022400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Photoderm Photoimm Photomed"],"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background\/Purpose<\/jats:title><jats:p>Tricyclic antidepressants (TCAs) are still widely used and are available to purchase without prescription in some countries. Awareness of adverse cutaneous drug reactions is essential.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>We reported a case of photo\u2010distributed hyperpigmentation due to imipramine and carried out a systematic search of the related articles using the search terms \u201ctricyclic antidepressants\u201d or \u201ctricyclic\u202fantidepressive\u202fagents\u201d,\u202fand \u201chyperpigmentation\u201d or \u201cphotosensitivity disorder\u201d. Fifty\u202fnon\u2010duplicate citations were identified of which 28 articles which were\u00a0independently assessed in full. The review was registered in PROSPERO,\u00a0CRD42018107338.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The remaining 25 articles met our inclusion criteria. Photo\u2010distributed hyperpigmentation tricyclic antidepressant\u2010induced photosensitivity reactions (TIPs) was the most common presentation. In 21 cases, this presented as an asymptomatic discolouration of exposed sites. Imipramine (81%), amitriptyline (9.5%), desipramine hydrochloride (4.8%) and mirtazapine (4.8%) were reported to be the culprit drugs. Nineteen were female with a mean age at presentation of 55\u00a0years. Mean duration from commencing the culprit drug until the development of discolouration was 10.4\u00a0years. Mean daily dose was 222.7\u00a0mg for imipramine. Histology was characteristic with golden\u2010brown or brownish granules deposited in dermis. Staining for Masson\u2010Fontana and MEL\u20105 was positive in all cases. Phototesting had not been done in cases prior to ours (negative 3\u00a0months after discontinuation of imipramine). Three further reports of suspected TIP presented with non\u2010specific and eczematous eruption. The two presentations were reported along with systemic problems (thrombocytopenia and hepatic injury).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This systematic review highlights the characteristic features of exposed site hyperpigmentation of TCA\u2010induced photosensitivity occurring after prolonged drug exposure in many cases.<\/jats:p><\/jats:sec>","DOI":"10.1111\/phpp.12724","type":"journal-article","created":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T19:27:00Z","timestamp":1628278020000},"page":"112-122","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Tricyclic antidepressant\u2010induced photosensitivity; A case report and systematic review"],"prefix":"10.1111","volume":"38","author":[{"given":"Einapak","family":"Boontaveeyuwat","sequence":"first","affiliation":[{"name":"Photobiology Unit St John's Institute of Dermatology Guy's and St Thomas' NHS Foundation Trust  London UK"},{"name":"Photodermatology Unit Division of Dermatology Department of Medicine King Chulalongkorn Memorial Hospital and Faculty of Medicine Chulalongkorn University  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mia","family":"Steyn","sequence":"additional","affiliation":[{"name":"Photobiology Unit St John's Institute of Dermatology Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Rickaby","sequence":"additional","affiliation":[{"name":"Dermatopathology Department Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John P","family":"Mcfadden","sequence":"additional","affiliation":[{"name":"Photobiology Unit St John's Institute of Dermatology Guy's and St Thomas' NHS Foundation Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert P. 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