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Pseudoporphyria and nonsteroidal antiinflammatory agents in children with juvenile idiopathic arthritis
B De Silva1, L Banney, W Uttley
1Department of Dermatology, Royal Infirmary of Edinburgh, and Department of Paediatric Rheumatology, Royal Hospital for Sick Children, Edinburgh, Scotland. BDeS2.excite.com
Insights
Pseudoporphyria, a skin condition, affects children using nonsteroidal anti-inflammatory drugs (NSAIDs). Naproxen and blue/gray eyes are identified as key risk factors, necessitating cautious prescribing to prevent scarring.
Area of Science:
- Pediatric Rheumatology
- Dermatology
- Pharmacology
Background:
- Pseudoporphyria presents with skin issues like blistering and scarring on sun-exposed areas.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are suspected causes of pseudoporphyria.
Purpose of the Study:
- To determine the prevalence of pseudoporphyria in children with juvenile idiopathic arthritis (JIA).
- To identify specific NSAIDs and patient factors associated with pseudoporphyria development in this pediatric cohort.
Main Methods:
- A 1-year prospective study was conducted.
- Children attending a pediatric rheumatology clinic in Edinburgh were evaluated.
- Data on NSAID use and patient characteristics, including eye color, were collected.
Main Results:
- The prevalence of pseudoporphyria was 10.9% among children with JIA using NSAIDs.
- Naproxen was the most frequently implicated NSAID, irrespective of dose.
- Blue/gray eye color emerged as an independent risk factor for pseudoporphyria.
Conclusions:
- NSAIDs, particularly naproxen, are associated with pseudoporphyria in children with JIA.
- Blue/gray eye color increases the risk of developing this condition.
- Caution is advised when prescribing naproxen to pediatric patients, especially those with blue/gray eyes, to prevent disfiguring facial scarring.
Abstract:
Pseudoporphyria is characterized by erythema, blistering, and scarring on sun-exposed skin. Nonsteroidal antiinflammatory drugs (NSAIDs) are implicated in the etiology of this condition. In a 1-year prospective study of children attending the pediatric rheumatology clinic in Edinburgh we found a prevalence of pseudoporphyria of 10.9% in children taking NSAIDs for juvenile idiopathic arthritis. Naproxen was the most commonly implicated NSAID, independent of dosage. Blue/gray eye color was an independent risk factor for the development of pseudoporphyria. We would advise caution in prescribing naproxen in these children to prevent disfiguring facial scarring.