Internal Medicine

0521779407-17 CUNY1086/Karliner 0 521 77940 7 June 13, 2007 7:57

1174 Photosensitivity Pituitary Tumors

General Measures

■Remove the patient from exposure – light and drug/antigen where

appropriate

specific therapy

■PMLE – Avoidance of light, topical or systemic corticosteroids, oral

antimalarials

■LE – broad spectrum sunscreens, photoprotective clothing, topical

corticosteroids, oral antimalarials

■PCT – treat concomitant Hepatitis C, phlebotomy or antimalarials

➣Antimalarial therapy may result in a toxic reaction, so the dose

must start very low.

■Pseudoporphyria – discontinue the causative agent

follow-up

■PMLE – follow to be certain that LE is not the correct diagnosis

■LE – see cutaneous LE chapter

■Pseudoporphyria – some of the NSAIDs cross-react. It may take

weeks to months for the eruption to clear.

complications and prognosis

■Dependent upon the diagnosis

PITUITARY TUMORS

ANDREW R. HOFFMAN, MD

history & physical

History

■Weakness, fatigue

■Infertility

■Amenorrhea/oligoamenorrhea

■Weight loss

■Absent or delayed puberty

■Cushing syndrome

■Acromegaly, galactorrhea

Signs & Symptoms

■General: headache, visual field cut, decreased libido, impotence

■Hypopituitarism: fatigue, cachexia, cold intolerance, constipation,

diminished pubic/axillary hair, inability to lactate, orthostatic

hypotension, hypoglycemia, dry, pale, wrinkled skin