To the Editor.—
We report a case of a severe, drug-induced, photosensitivity reaction induced by a new oral quinolone antibiotic, and possibly aggravated by subsequent methotrexate use.
Report of a Case.—
A 50-year-old woman with a known history of psoriasis vulgaris with pustular flares was seen. Her usual medications included 17.5 mg of methotrexate weekly, diflunisal (Dolobid), conjugated estrogens (Premarin), potassium, and occasional furosemide (Lasix). In June 1988, she was given a ten-day course of ciprofloxacin (Cipro, 500 mg twice a day) for a sore throat and possible joint infection. Four days after completing the course of ciprofloxacin, she received sun exposure on a Florida beach. She was protected by generous application of a sunscreen (SPF 29), as well as by a hat, umbrella, and a towel across her legs. She estimates the time spent in direct sun as less than 15 minutes. She also reports many longer sun