KUMJ | VOL. 24 | NO. 2 | ISSUE 95 | APRIL - JUNE, 2026

Pirfenidone Induced Photosensitive Rash in Idiopathic Pulmonary Fibrosis
KC S, Salih NM, Aryal S

Abstract:
Idiopathic pulmonary fibrosis (IPF) is a gradually worsening interstitial lung disease ordinarily managed with anti-fibrotic agents such as pirfenidone, which has been shown to slow the disease progression but may be linked with adverse effects such as gastrointestinal intolerance and cutaneous reactions. Awareness of photosensitivity as a potential side effect is essential to ensure treatment adherence as well as patient safety. We report the case of a 63-year-old gentleman with moderately severe IPF who was started on oral pirfenidone and consequently developed a widespread erythematous rash within one month, initially affecting sun-exposed areas before becoming more generalised. Dermatological assessment suggested a photosensitive reaction, and the patient was acknowledged as lack of awareness regarding sun-protection measures. Pirfenidone was quickly discontinued, and he was started on oral and topical corticosteroids alongside counselling on strict sun protection. Skin biopsy was performed and histopathological findings were persistent with photosensitive dermatitis. The rash resolved gradually over two to three weeks without residual changes, and there was no recurrence on followup with continuous adherence to sun-protective measures. This case highlights the importance of being familiar with pirfenidone-induced photosensitivity and highlighting preventive advice when initiating therapy.
Keyword : Antifibrotic therapy, Idiopathic pulmonary fibrosis (IPF), Phototoxic dermatitis, Pirfenidone