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Diclofenac-induced pseudoporphyria; an under-recognized condition?

N Turnbull¹, M Callan, R C D Staughton

¹Pathology Department, Warwick Hospital, Warwick, UK.

Clinical and Experimental Dermatology

|March 19, 2014

Summary

Pseudoporphyria, a blistering skin condition, can be triggered by medications like diclofenac, even when considered safe. This case highlights the importance of considering drug-induced pseudoporphyria in patients with psoriatic arthritis.

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Area of Science:

Dermatology
Toxicology

Background:

Pseudoporphyria is a photodistributed bullous disorder clinically resembling porphyria cutanea tarda (PCT) but lacking abnormal porphyrin biochemistry.
Risk factors include renal failure, dialysis, excessive ultraviolet A exposure, and certain medications, notably nonsteroidal anti-inflammatory drugs (NSAIDs).

Observation:

This report details a case of pseudoporphyria induced by diclofenac in a male patient diagnosed with psoriatic arthritis.
This represents the second documented instance of diclofenac-associated pseudoporphyria.

Findings:

Diclofenac, an NSAID, can precipitate pseudoporphyria, a condition mimicking PCT without biochemical abnormalities.
The patient's psoriatic arthritis was being treated with diclofenac when pseudoporphyria developed.

Implications:

Diclofenac, previously viewed as a safe NSAID alternative for pseudoporphyria, should be used with caution.
This case underscores the need for heightened awareness among dermatologists regarding drug-induced pseudoporphyria, even with commonly prescribed medications.