Phototoxic Rash during Therapy with Pramipexole in a Patient with Restless Legs Syndrome

Sir, drug-related phototoxic reaction is a well-established clinical entity. historically, antineoplastic cytotoxic agents such as actinomycin c, doxorubicin, and fluoroquinolones are the most common drugs to cause phototoxic reactions in humans.1 dopamine agonists, ropinirole, and pramipexole are considered the first line of treatment for restless legs syndrome (rls) in current evidenced-based guidelines, and to the best of our knowledge, no dermatological side-effects have been described in association with its use.2 we describe a case of a man with rls who developed a rare photosensitive rash due to pramipexole. a 57-year-old male presented to the department of dermatology at san cecilio university hospital, granada, spain, with a 3-day history of itchy, erythematous rash and swelling on his face and arms. other complaints included breathlessness and dysphonia. he had a past medical history of thyroidectomy and subsequent hypothyroidism, for which he took daily thyroxine. two weeks before the rash had started, he had been diagnosed with rls in the neurology department of our hospital, and a nightly dose of 0.3 mg of pramipexole had been prescribed.