Sometimes photosensitizing drugs may also cause pseudoporphyria (skin lesions similar to porphyria cutanea tarda), e.g., after exposure to naproxen, nalidixic acid, tetracycline, sulfonylureas, furosemide, dapsone, amiodarone, etc.
Pathogenesis, characteristics, diagnosis and treatment of pseudoporphyria. Curr Opin Dermatol.
This has been reported following tetracycline hydrochloride as well as in five types of cutaneous porphyria (porphyria cutanea tarda, erythropoietic porphyria, erythropoietic protoporphyria, and variegate porphyria as well as in pseudoporphyria
The differential diagnosis includes phototoxic and photoallergic skin reactions, porphyrias and pseudoporphyria
, lupus erythematosus, and polymorphous light eruption.
also presents with skin blistering, but porphyrins are normal.
Solar rashes such as urticaria, actinic prurigo, polymorphic light eruptions, chronic dermatitis, and pseudoporphyria
When considering a diagnosis of EP, you'll need to rule out erythropoietic protoporphyria, porphyria cutanea tarda, variegate porphyria, xeroderma pigmentosum, and pseudoporphyria
. The natural history of EP lesions, clinical examination, and lab work will help you make the diagnosis.
Miami Bureau Cutaneous Reaction Patterns to Drugs Clinical Pattern Selected Drug Examples Acneiform lithium, corticosteroids, androgens Lichenoid thiazides, antimalarials, captopril Fixed drug eruption tetracyclines, sulfonamides, barbiturates Morbilliform beta-lactam antibiotics, calcium channel blockers Urticarial beta-lactam antibiotics, aspirin Pityriasis rosea-like captopril, gold Pigmentation minocycline, antimalarials, bleomycin Subacute lupus-like hydrochlorothiazide, terbinafine Systemic lupus-like procainamide, hydralazine, minocycline Serum sickness-like cefaclor, minocycline Pemphigus-like captopril, penicillamine Pseudoporphyria
naproxen, furosemide Photosensitivity doxycycline, thiazides, sulfonylureas Source: Dr.
Skin diseases that were studied and evaluated are detailed in Table 1 but also included the following: perforating disorders; calciphylaxis; porphyria and pseudoporphyria
; onychomycosis; clubbing; horizontal nail ridging; Terry's nail; hypersensitivity rashes; and malignant skin lesions.
This type of atrophia maculosa varioliformis cutis, which is more frequently referred to as anetoderma or drug-induced pseudoporphyria
, can occur in patients taking other NSAIDs but the incidence appears to be highest in those taking naproxen.
These patients were therefore labeled as having "pseudoporphyria
of renal failure".