Naproxeninduzierte Pseudoporphyrie

Abstract

A 12 year old boy developed scars at light-exposed areas following long-term therapy with naproxen for rheumatoid arthritis. Erythrocyte and urine porphyrin levels were not increased, and there was no evidence of increased photosensitivity. Pseudoporphyria is reported in 10-20% of those treated with naproxen for > 4 weeks. As compared to other nonsteroidal anti-inflammatory agents, the specific risk for naproxen is increased about 6fold. While the underlying abnormality has not been elucidated, formation of phototoxic metabolites in a subgroup of genetically predisposed individuals has been suggested as the most likely mechanism. Both dermatologists and rheumatologists should be aware of the risk of naproxen-induced pseudoporphyria and discontinue therapy early in order to avoid scar formation in light-exposed areas.

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“…Numerous medications have been alleged to provoke PP, including nonsteroidal anti-inflammatory drugs (NSAIDs; especially propionic acid derivatives such as nabumetone, naproxen, oxaprozin and ketoprofen) [7-14], celecoxib [15], antibiotics (for instance, tetracycline and nalidixic acid) [16,17], diuretics (furosemide, triamterene with hydrochlorothiazide, chlortalidone and bumetanide) [18,19] and others (retinoids, cyclosporine, amiodarone, carisoprodol/acetylsalicyl acid, pyridoxine, flutamide, dapsone and oral contraceptive pills) [20-22]. …”