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Drug-Induced Pseudoporphyria: A Case Report.

Shivani D Jangid1, Vikrant Saoji1, Bhushan Madke1

  • 1Dermatology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.

Cureus
|May 6, 2024
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Summary

Pseudoporphyria is a skin condition that mimics porphyria cutanea tarda but has normal porphyrin levels. Early diagnosis and sun protection are key for managing this photosensitive dermatosis.

Keywords:
bullous dermatosesnon-steroidal anti-inflammatory drugs (nsaids)photosensitivity disorderspseudoporphyriawood’s lamp

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Area of Science:

  • Dermatology
  • Internal Medicine
  • Genetics

Background:

  • Pseudoporphyria is an uncommon skin disorder that clinically resembles porphyria cutanea tarda (PCT).
  • Accurate diagnosis requires excluding true porphyria due to distinct pathophysiologies and normal porphyrin profiles in pseudoporphyria.
  • Associated factors include chronic renal failure, hemodialysis, certain medications, and tanning bed use.

Observation:

  • The case involves a 20-year-old male presenting with photosensitivity and erosions/scars on sun-exposed areas, particularly the hands and face.
  • Clinical evaluation revealed no urine fluorescence under Wood's lamp, aiding in differential diagnosis.
  • Symptoms of skin fragility, bullae, milia, and scarring are characteristic of pseudoporphyria.

Findings:

  • The patient was diagnosed with pseudoporphyria based on clinical presentation and laboratory findings.
  • Treatment initiated included hydroxychloroquine sulfate and strict ultraviolet protection.
  • Drug-induced pseudoporphyria typically resolves within weeks to months after discontinuing the offending photosensitizing agent.

Implications:

  • This case highlights the importance of recognizing pseudoporphyria and differentiating it from PCT.
  • Management emphasizes identifying and removing causative agents (e.g., drugs, environmental exposures) and rigorous photoprotection.
  • Understanding the pathophysiology, though often unknown, is crucial for effective patient care and preventing long-term scarring.