[Naproxen-induced pseudoporphyria]

Area of Science:

• Dermatology
• Rheumatology
• Pharmacology

Background:

• Rheumatoid arthritis treatment often involves nonsteroidal anti-inflammatory drugs (NSAIDs).
• Naproxen is a commonly prescribed NSAID for managing rheumatoid arthritis symptoms.

Observation:

• A pediatric patient developed scarring on light-exposed skin after prolonged naproxen therapy.
• No elevated porphyrin levels or increased photosensitivity were detected in the affected individual.

Findings:

• Pseudoporphyria, a skin condition, occurs in 10-20% of patients on naproxen for over four weeks.
• Naproxen presents a sixfold increased risk for pseudoporphyria compared to other NSAIDs.
• The exact mechanism remains unclear, but phototoxic metabolite formation in susceptible individuals is hypothesized.

Implications:

• Dermatologists and rheumatologists must recognize the risk of naproxen-induced pseudoporphyria.
• Promptly discontinuing naproxen therapy can prevent irreversible scarring in at-risk patients.