# Doxycycline-Induced Phototoxicity Localized to Vitiligo-Affected and Sun-Exposed Skin

## TL;DR

A patient with vitiligo experienced doxycycline-induced phototoxicity only in depigmented and sun-exposed skin, highlighting increased risk in those with pigmentary disorders.

## Contribution

This case demonstrates localized phototoxicity in vitiligo-affected skin, emphasizing melanin's protective role and the need for photoprotection in such patients.

## Key findings

- Doxycycline-induced phototoxicity occurred selectively in vitiliginous and sun-exposed skin.
- Symptoms resolved completely after discontinuation of doxycycline.
- Patients with pigmentary disorders may be at higher risk for localized phototoxic reactions.

## Abstract

Vitiligo is a chronic autoimmune disorder characterized by depigmented skin secondary to melanocyte loss, which may increase susceptibility to phototoxic drug reactions. We describe a case of doxycycline-induced phototoxicity selectively affecting vitiliginous and sun-exposed skin, with complete resolution after drug discontinuation. This case highlights melanin’s protective role against ultraviolet-mediated injury and demonstrates that patients with pigmentary disorders may be at higher risk for localized phototoxic reactions from photosensitizing medications. Clinicians should maintain vigilance, emphasize photoprotection, and consider alternative therapies with a lower risk of phototoxicity in such populations.