Pseudoporphyria following self‐medication with chlorophyll

Abstract

Two cases of pseudoporphyria are described in which the clinical features of porphyria cutanea tarda occurred in the absence of abnormalities in porphyrin metabolism. Both patients presented with skin fragility and bullae on the dorsal aspect of the hands. The patients consumed a commercial liquid chlorophyll drink in which we detected fluorescent compounds with characteristics typical of previously described chlorophyll derived photosensitisers.

Pseudoporyphyria Associated with Lemon Water and Naproxen

“…In Australia, chlorophyll is marketed by several vitamin companies as a natural super antioxidant food supplement. This chlorophyll has been reported as a known trigger for pseudoporyphyria [14,16,17]. The lemon water which the patient ingested may contain pheophorbide-a which may be responsible for the outbreaks Another possible trigger for our patient's PP is the use of naproxen for pain relief [18].…”

“…Chlorophyll-derived photosensitization has been found in ruminant livestock and photosensitizing metabolites such as pheophorbide-a and phytoporphyrin. It has also have been demonstrated in Japanese patients who were self-medicating with commercial extracts of Chlorella algae [14]. Furthermore, in previous studies, researchers have found a substance called pheophorbide-a that results from the chemical procedures used to extract the chlorophyll from the plant.…”

“…PP has also been reported with exposure to chlorophyll in various forms [14]. Chlorophyll is a natural constituent of the human diet, occurring naturally in green leafy vegetables such as spinach, and is usually metabolized without causing any symptoms.…”

Chlorophyll‐induced pseudoporphyria with ongoing photosensitivity after cessation – a case series of four patients

“…4 The second series was an Australian report of two chlorophyll-induced pseudoporphyria cases. 5 In both series, symptoms resolved following chlorophyll cessation. Animal studies have shown that the chlorophyll metabolites pheophorbide-a, pyropheophorbide-a and phytoporphyrin may be responsible for its photosensitivity.…”

“…Zhao, 1,2 J.W. Frew, 2,3 J. Muhaidat, 4 K. Cheung, 4 P. Lee, 5 V. Poulos, 6 I. McCrossin, 7 A.R. Cachia, 3 F. Tefany, 3,8 Tattooing may cause lifethreatening latex allergy Editor There are two types of latex allergy; Type I reaction where IgE antibodies to natural rubber latex proteins potentially may cause anaphylactic reactions, and Type IV allergy to chemicals used in production as accelerators and antioxidants, which can cause allergic contact dermatitis.…”