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Pirfenidone Photosensitivity — RACP Adult Medicine MCQ

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EasyClinical PharmacologyPirfenidone PhotosensitivityRACP Adult Medicine

A 62-year-old man with IPF on pirfenidone develops photosensitivity with a severe sunburn-like rash after minimal sun exposure. What is the mechanism and management?

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Correct answer: DContact dermatitis

Pirfenidone commonly causes photosensitivity (8–12% of patients) through a phototoxic mechanism. Management includes strict sun avoidance, broad-spectrum SPF 50+ sunscreen, protective clothing, and timing outdoor activity to avoid peak UV hours. Dose reduction may be needed during summer months. It does NOT require permanent cessation unless phototoxicity is severe and unmanageable. Patients should be counselled about photosensitivity risk BEFORE starting pirfenidone. The alternative antifibrotic (nintedanib) does not cause photosensitivity but has GI side effects instead.

Reference: AMH – 2025 – Pirfenidone; eTG – 2025 – Respiratory