Drug-Induced Lichenoid Photosensitivity: A Case Report

Tuberculosis (TB) is a highly contagious airborne bacterial infection and continues to be one of the leading causes of mortality worldwide. First-line antitubercular therapy (ATT), including isoniazid, rifampicin, pyrazinamide, and ethambutol, is essential for TB management but is associated with adverse drug reactions (ADRs), including severe cutaneous manifestations. Managing these ADRs poses significant challenges, as discontinuation of ATT, combined with systemic steroid use, may increase the risk of disease progression and multidrug resistance. Drug-induced lichenoid photosensitivity is an uncommon yet clinically significant skin-related adverse reaction to ATT. Its unpredictable onset and clinical resemblance to autoimmune disorders make early recognition and accurate diagnosis essential to avoid mismanagement or delays in treatment. Timely identification and appropriate intervention are critical not only for minimizing complications but also for maintaining uninterrupted TB therapy. This case report highlights the importance of recognizing and effectively managing drug-induced lichenoid photosensitivity associated with antitubercular agents. We describe a 62-year-old male diagnosed with cervical tuberculous lymphadenitis who developed this rare cutaneous adverse reaction during ATT. The case underscores the need for early diagnosis, individualized treatment strategies, and the vital role of pharmacovigilance in promoting patient safety and ensuring the uninterrupted continuation of TB management.