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Pseudoporphyria associated with Relafen therapy.

C M Magro1, A N Crowson

  • 1Ameripath Cutaneous Pathology and Immunofluorescence, Cleveland, Ohio 44122, USA.

Journal of Cutaneous Pathology
|April 3, 1999
PubMed
Summary
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Nonsteroidal anti-inflammatory drugs (NSAIDs) like nabumetone can cause pseudoporphyria. Underlying connective tissue disease may increase the risk of developing this rare skin condition.

Area of Science:

  • Dermatology
  • Rheumatology
  • Pharmacology

Background:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) are linked to pseudoporphyria, but the exact cause is unclear.
  • Nabumetone, a novel NSAID, is popular for its reduced gastrointestinal effects.
  • Pseudoporphyria is a rare side effect listed for nabumetone in the Physician's Desk Reference (PDR).

Observation:

  • Four patients developed blisters and erosions on sun-exposed skin within four months of starting nabumetone.
  • Skin biopsies revealed characteristic clinical, light microscopic, and immunofluorescent (IF) findings of pseudoporphyria.
  • Patients' histories included rheumatoid arthritis (RA), mixed connective tissue disease (MCTD), and diltiazem use; all had antinuclear antibodies.

Findings:

  • Confirmed diagnosis of pseudoporphyria in all four patients, excluding elevated urine porphyrin levels.

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  • Skin biopsies showed features associated with connective tissue disease (CTD), such as vascular changes and immune deposits.
  • Nabumetone was identified as a potential trigger for pseudoporphyria.

    • Implications:

    • Nabumetone can induce pseudoporphyria.
    • Patients with underlying connective tissue disease may be more susceptible to drug-induced pseudoporphyria.
    • This study highlights the importance of considering drug side effects in patients with connective tissue diseases.