Blisters, ulcers, crusts, and atrophic scars on the back of the hands and the extensor aspects of the forearms

Weidner, Till; Tittelbach, Jörg; Schliemann, Sibylle; Goetze, Steven; Elsner, Peter

doi:10.1111/ddg.13330

Cited by 4 publications

(3 citation statements)

References 8 publications

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“…Cutaneous and histologic manifestations of pseudoporyphyria are the same as poryphyria cutanea tarda (PCT) with the appearance of skin fragility features. Clinical manifestation of these conditions include bullae, vesicles, and scarring on superficial sun exposed skin, and histology characteristically shows non-inflammatory, subepidermal bulla with pauci perivascular lymphocytic infiltrate [5]. However, pseudoporphyria can be differentiated from poryphyria cutanea tarda by the presence of normal porphyrin levels in plasma, erythrocytes, urine, and stool [6].…”

Section: Discussionmentioning

confidence: 99%

Pseudoporyphyria Associated with Lemon Water and Naproxen

Okwundu¹,

Moesch²,

Belden³

2020

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Background: Pseudoporyphyria is an uncommon bullous dermatosis. It shares clinical and histological features with porphyria cutanea tarda, but it occurs in the absence of porphyrin metabolic dysfunction. It is characterized by skin fragility, bullae, milia, and scarring on the dorsum of the hands and other sun-exposed areas. Case: We present a patient on naproxen with recurrent pseudoporyphyria of the dorsal hands associated with the consumption of lemon water. Findings: Biopsy showed a pauci-inflammatory sub epidermal vesicle with caterpillar bodies and laboratory studies lacked any urine or serum porphyrin abnormalities. The cutaneous lesions were noted to resolve with discontinuation of the consumption of lemon water. Keywords: Pseudoporyphyria; Porphyrin; Porphyria Cutanea Tarda; Chlorophyll; Vesicle and Depigmented

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Section: Discussionmentioning

confidence: 99%

Pseudoporyphyria Associated with Lemon Water and Naproxen

Okwundu¹,

Moesch²,

Belden³

2020

CRDOA

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“…The typical clinical presentation is the presence of blisters and vesicles on the hands, forearms, face, legs or feet. However, there are reports of cases that occurred without typical bullous presentation, with the development of crusts and ulcers, the diagnosis being confirmed by histological characteristics 9. Skin frailty and easy bruises after minor trauma are also common complaints 10…”

Section: Discussionmentioning

confidence: 99%

Furosemide-induced pseudoporphyria in a patient with chronic kidney disease: case report

et al. 2018

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Introduction: Pseudoporphyria is a rare photodermatosis with characteristics similar to those of porphyria cutanea tarda, without, however, presenting abnormalities in porphyrin metabolism. Its etiology is related to chronic kidney disease, ultraviolet radiation and certain medications. The aim of the present study is to describe a case of furosemide-related pseudoporphyria in a patient with chronic kidney disease. Case description: A 76-year-old male patient with stage 4 chronic kidney disease and in continuous use of furosemide presented ulcerated lesions with peripheral erythema and central hematic crust in the legs. On a skin infection suspicion, treatment with quinolone and neomycin sulfate was initiated, without improvement. A biopsy of the lesion was performed, with histopathological examination demonstrating findings compatible with porphyria, although the patient did not present high porphyrin levels. The diagnosis of furosemide-induced pseudoporphyria was then established, with medication suspension, and there was a significant improvement of the lesions. Discussion: There are few cases of pseudoporphyria described, but it is believed that this condition is underdiagnosed, especially in patients with chronic kidney disease. Both clinical and histopathological findings closely resemble porphyria, differentiating it from normal levels of porphyrin in plasma, urine, or feces. Conclusions: Although the lesions are mostly benign, they may increase the morbidity and mortality of these patients, so a proper diagnosis and early treatment are extremely important.

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“…Pseudoporphyria is another differential diagnosis. It is caused by several medications, including non-steroidal anti-inflammatory drugs, leading to similar skin eruptions in UV-light exposed skin, while porphyrin analysis is within the normal range ( 7 ). Treatment of patients with PCT aims at reduction of iron overload, mainly by avoiding predisposing factors.…”

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confidence: 99%