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J Allergy Clin Immunol Pract 2019 Feb 25;7(2):653-654. Epub 2018 Sep 25.

Division of Allergy and Clinical Immunology, Department of Medicine, East Tennessee State University, Johnson City, Tenn. Electronic address:

Indian J Dermatol Venereol Leprol 2018 Nov-Dec;84(6):652-659

Department of Dermatology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.

N-acetylcysteine is a mucolytic drug which is commonly used as an antidote for acetaminophen toxicity. It is a thiol compound, which acts as a donor of cysteine, leading to replenishment of glutathione and thus acts as an antioxidant. It also has anti-inflammatory effects, alters the levels of neurotransmitters, inhibits proliferation of fibroblasts and keratinocytes and causes vasodilatation. Read More

Acta Derm Venereol 2019 01;99(1):26-32

Center for Blistering Diseases, Department of Dermatology, University Medical Center Groningen, Hanzeplein 1, NL-9700 RB Groningen, The Netherlands.

Mechanobullous epidermolysis bullosa acquisita (mEBA) can have a clinical presentation that is very similar to other blistering diseases, such as porphyria cutanea tarda (PCT) and pseudoporphyria. Direct immunofluorescence is an important feature in the diagnosis of mEBA, although features that overlap with PCT and pseudoporphyria have been reported. This retrospective observational study investigated whether direct immunofluorescence can discriminate mEBA from PCT and pseudoporphyria. Read More

J Bras Nefrol 2018 Jul-Sep;40(3):287-290. Epub 2018 Jul 10.

Universidade Federal do Paraná, Complexo Hospital de Clínicas, Departamento de Nefrologia, Curitiba, PR, Brasil.

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. Read More

J Eur Acad Dermatol Venereol 2019 Jan 20;33(1):56-62. Epub 2018 Jul 20.

Photodermatology Department, Hospital Clinic de Barcelona, Barcelona, Spain.

First described in 1961, photoonycholysis (PO) is a rare nail alteration that may result from drug intake, from topical aminolevulinate photodynamic therapy or from photosensitive conditions such as porphyria or pseudoporphyria. Spontaneous PO is rare. This review updates the numerous causes of PO and highlights some new ways producing this condition. Read More

Actas Dermosifiliogr 2018 Oct;109(8):e11-e16

Servicio de Dermatología, Hospital Universitario de Cabueñes, Gijón, Asturias, España.

Blisters associated with PUVA treatments are an adverse effect of photochemotherapy that has been reported in the literature. Asymptomatic blisters appear spontaneously mainly on the lower limbs and resolve without treatment. The differential diagnoses to consider include a phototoxic reaction, pseudoporphyria, and PUVA-induced bullous pemphigoid. Read More

Am J Case Rep 2018 Jan 15;19:52-56. Epub 2018 Jan 15.

Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA.

BACKGROUND Bullosis diabeticorum (BD) is a condition characterized by recurrent, spontaneous, and non-inflammatory blistering in patients with poorly controlled diabetes mellitus. While etiopathogenesis remains unclear, roles of neuropathy, vasculopathy and UV light are hypothesized. Most literature reports negative direct and indirect immunofluorescence findings in diabetics with bullous eruptions. Read More

Clin Exp Dermatol 2018 Jun 8;43(4):463-466. Epub 2018 Jan 8.

Department of Dermatology, Hospital Universitario de La Princesa, Diego de León 62, Madrid, 28006, Spain.

Int J Dermatol 2017 Jun 21;56(6):e106-e117. Epub 2017 Mar 21.

Dermatology, Rutgers New Jersey Medical School, Newark, NJ, USA.

Porphyrias are a group of intriguing genetic diseases of the heme pathway, of which porphyria cutanea tarda (PCT) is the most common. Resulting from a defect in enzymes in the porphyria pathway, PCT has been linked to several conditions. Recent studies have demonstrated a change in thinking regarding the human immunodeficiency virus (HIV) and development of PCT. Read More

Ugeskr Laeger 2016 12;178(51)

J Biomol Struct Dyn 2018 02 16;36(2):335-350. Epub 2017 Jan 16.

a Molecular Modelling and Drug Design Research Group, School of Health Sciences, University of KwaZulu-Natal , Westville , Durban 4000 , South Africa.

Recent studies have linked a deadly form of prostate cancer known as metastatic castration-resistant prostate cancer to retinoic acid-related orphan-receptor gamma (ROR-γ). Most of these studies continued to place ROR-γ as orphan because of unidentifiable inhibitor. Recently identified inhibitors of ROR-γ and their therapeutic potential were evaluated, among which inhibitor XY018 was the potent. Read More

Int Wound J 2017 Feb 17;14(1):288-292. Epub 2016 Oct 17.

Department of Dermatology and Immunodermatology, Medical University of Warsaw, Warsaw, Poland.

Haemodialysis is the most frequent form of renal replacement therapy (RRT) in patients with end-stage renal disorder (ESRD). Patients with ESRD frequently develop skin problems, mainly xerosis, pruritus and hyperpigmentation, as well as bullous diseases, mainly porphyria or pseudoporphyria and, in some cases, bullous pemphigoid (BP). BP is the most common autoimmune sub-epidermal blistering disease, and it predominantly affects elderly people. Read More

Indian J Dermatol Venereol Leprol 2016 Nov-Dec;82(6):727-729

Department of Dermatology, Fortis Hospital, New Delhi, India.

Hemodial Int 2016 Jul 2;20(3):E14-E18. Epub 2016 Feb 2.

Department of Pathology, General Hospital Hippokrateion, Thessaloniki, Greece.

Hemodialysis patients present with a broad spectrum of specific and nonspecific skin disorders, which rarely coexist. We report an exceptional case of a hemodialysis patient that developed acquired reactive perforating collagenosis and pseudoporphyric bullous dermatosis on the basis of common skin disorders which include hyperpigmentation, pruritus, xerosis cutis, and Linsday's nails. Interestingly, our patient presented with two unusual but distinctive cutaneous dermopathies on the background of other commonly seen skin alterations. Read More

Indian J Nephrol 2015 Sep-Oct;25(5):307-9

Department of Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India.

Pseudoporphyria (PP) is used to describe a photodistributed bullous disorder with clinical and histologic features of porphyria cutanea tarda (PCT) but without accompanying biochemical porphyrin abnormalities. Medications, excessive sun and ultraviolet radiation exposure, have all been reported to develop PP. We report a case of PP in a 49-year-old man with CKD stage 3a, caused due to torsemide intake. Read More

J Pediatric Infect Dis Soc 2015 Jun 4;4(2):e22-4. Epub 2014 Jul 4.

Infectious Diseases Division, Department of Pediatrics.

Voriconazole is a triazole antifungal agent superior to amphotericin B in the treatment of invasive aspergillosis. It is generally well tolerated and has excellent oral bioavailability, providing significant benefit in the treatment of invasive fungal infections. There have been numerous reports of dermatologic reactions to this agent, including erythroderma, cheilitis, Stevens-Johnson syndrome, discoid lupus erythematosus, pseudoporphyria, squamous cell carcinoma, and photosensitivity reactions. Read More

Indian J Dermatol 2015 May-Jun;60(3):324

Department of Pathology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India.

G Ital Dermatol Venereol 2015 Jun;150(3):327-9

Unit of Dermatology, NESMOS Department, Faculty of Medicine, Sant'Andrea" Hospital "Sapienza" University, Rome, Italy -

Pseudoporphyria refers to a rare bullous dermatosis characterized by the clinical and histological features of porfiria cutanea tarda without abnormalities in porphyrin metabolism. The pathogenesis is heterogeneous and several exogenous factors may promote the bullous lesion formation, including medications, end stage renal disease, dialysis and tanning beds. Regarding treatment of this condition, in literature different therapy have been reported, such as glutathione and his precursor N-acetylcysteine, which presents anti-oxidant properties; however even more toxic drugs, such as chloroquine, are used. Read More

J Photochem Photobiol B 2015 Jul 27;148:168-173. Epub 2015 Apr 27.

Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Medical University of Silesia, Jagiellońska 4, PL 41-200 Sosnowiec, Poland.

Tetracycline is a semisynthetic antibiotic and is used in several types of infections against both gram-positive and gram-negative bacteria. This therapy is often associated with phototoxic reactions that occur after exposure to UV radiation and lead to photo-onycholysis, pseudoporphyria, solar urticaria and the fixed drug eruption in the skin. The phototoxic reactions may be related to the melanin content which, on one side may bind drugs - leading to their accumulation, and on the other side, they have photoprotective and antioxidant properties. Read More

Ugeskr Laeger 2015 Apr;177(17)

Dansk BørneAstma Center, Ledreborg Alle 34, 2850 Gentofte.

Pseudoporphyria cutanea tarda is a well described bullous skin disorder which resembles porphyria cutanea tarda. However, the levels of porphyrins in plasma, urine and faeces are normal. We present three cases of patients with classical symptoms of pseudoporphyria. Read More

Perit Dial Int 2015 Mar-Apr;35(2):234-5

Department of Internal Medicine, Division of Nephrology, Marmara University, School of Medicine, Istanbul, Turkey.

J Eur Acad Dermatol Venereol 2016 Jul 16;30(7):1239-42. Epub 2015 Apr 16.

Dermatology, St George Hospital, Sydney, Australia.

Ugeskr Laeger 2015 Feb;177(6)

Medicinsk Afdeling, Odense Universitetshospital, Svendborg Sygehus, Valdemarsgade 53, 5700 Svendborg.

Pseudoporphyria is a photosensitive bullous disease, which resembles porphyria cutanea tarda. Normal porphyrin levels in urine, stool and blood define pseudoporphyria. Pseudoporphyria is associated with chronic renal failure, haemodialysis, a variety of drugs (e. Read More

Ann Dermatol Venereol 2014 Dec 18;141(12):815-6. Epub 2014 Oct 18.

Département de dermatologie et allergologie, bâtiment des spécialités médicales, allée du Morvan, 54500 Vandœuvre-lès-Nancy, France. Electronic address:

Chem Res Toxicol 2014 Nov 14;27(11):1990-5. Epub 2014 Oct 14.

Instituto de Tecnología Química UPV-CSIC, Universitat Politècnica de València , Avda de los Naranjos s/n, 46022 Valencia, Spain.

Imatinib (IMT) is a promising tyrosine kinase inhibitor used in the treatment of some types of human cancer. It constitutes a successful example of rational drug design based on the optimization of the chemical structure to reach an improved pharmacological activity. Cutaneous reactions, such as increased photosensitivity or pseudoporphyria, are among the most common nonhematological IMT side effects; however, the molecular bases of these clinical observations have not been determined. Read More

J Cosmet Laser Ther 2014 Dec 25;16(6):314-6. Epub 2014 Sep 25.

Department of Dermatology, Clínica Universidad de Navarra , Pamplona , Spain.

Voriconazole is an antifungal agent mainly used against aspergillosis. Given its wide spectrum of action and limited adverse effects, it has replaced amphotericin B as the drug of choice in the prophylactic treatment of immunocompromised patients. Several adverse effects are caused by this drug with dermatological reactions accounting for 6% of the total. Read More

Australas J Dermatol 2015 Feb 15;56(1):47-8. Epub 2014 Aug 15.

Pathwest Laboratory Medicine, QE II Medical Centre, Australia.

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. Read More

J Drugs Dermatol 2014 Aug;13(8):990-2

Pseudoporphyria describes a photodistributed bullous disorder with negative urinary, fecal, and serum porphyrin studies. Although pseudoporphyria is thought to be extremely rare (less than 100 reported cases4-5), we propose that this entity is underreported. One author (KB) has seen four cases of pseudoporphyria in the past four years. Read More

Pediatr Dermatol 2014 Sep-Oct;31(5):603-7. Epub 2014 Jun 12.

Department of Paediatric Dermatology, Starship Children's Health, Auckland, New Zealand.

Imatinib mesylate was the first of several tyrosine kinase inhibitors approved for use in the treatment of a number of human cancers. Adverse cutaneous reactions to imatinib are common. Pseudoporphyria has been infrequently reported in adults undergoing imatinib therapy for chronic myeloid leukemia. Read More

J Eur Acad Dermatol Venereol 2015 Sep 12;29(9):1848-50. Epub 2014 May 12.

Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain.

Postepy Dermatol Alergol 2014 Feb 25;31(1):53-5. Epub 2014 Feb 25.

Department of Dermatology, Silesian Medical University, Katowice, Poland. Head of Department: Prof. Ligia Brzezińska-Wcisło MD, PhD.

Pseudoporphyria is a condition identical to porphyria cutanea tarda (PCT) on clinical and histological grounds, but without any biochemical porphyrin abnormality. Excessive sunlight and UVA exposure (for example tanning beds), drugs such as: non-steroidal anti-inflammatory drugs, retinoids, antibiotics, diuretics and others are supposed to be etiological factors of pseudoporphyria. Cases of PCT and pseudoporphyria in patients with HCV infection and hemodialysed due to chronic renal failure were also described. Read More

Clin Exp Dermatol 2014 Apr;39(3):348-50

Pathology Department, Warwick Hospital, Warwick, UK.

Pseudoporphyria is a photodistributed bullous disorder that is clinically and histologically similar to porphyria cutanea tarda (PCT), but without abnormal porphyrin biochemistry. Renal failure, dialysis, excessive ultraviolet A and medications, particularly nonsteroidal anti-inflammatory drugs (NSAIDs), have been associated with pseudoporphyria. We report a case of diclofenac-induced pseudoporphyria in a man with psoriatic arthritis. Read More

J Eur Acad Dermatol Venereol 2015 Apr 11;29(4):827. Epub 2014 Mar 11.

Department of Dermato-Allergology, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.

Case Rep Dermatol Med 2013 10;2013:271873. Epub 2013 Apr 10.

Second Department of Dermatology, "Attikon" General University Hospital, University of Athens, 1 Rimini Street, 124 62 Chaidari, Greece.

Pseudoporphyria (PP) is a relatively rare, photodistributed bullous dermatosis that resembles porphyria cutanea tarda (PCT), but it is not accompanied by porphyrin abnormalities in the serum, urine, or stool. It was initially described in renal failure patients on dialysis. Thereafter, it has been associated with several aetiological factors. Read More

Hemodial Int 2013 Jul 5;17(3):466-7. Epub 2013 Mar 5.

Int J Dermatol 2014 Feb 3;53(2):e143-4. Epub 2013 Mar 3.

Department of Dermatology Hospital Donostia San Sebastian Spain E-mail:

J Drugs Dermatol 2012 Nov;11(11):1272

Semin Dial 2012 Jul;25(4):408-18

Department of Dermatology, Alpert Medical School of Brown University, Providence, Rhode Island 02903, USA.

Cutaneous abnormalities in patients with end-stage renal disease (ESRD) receiving hemodialysis or peritoneal dialysis may demonstrate signs of their underlying condition or reveal associated disease entities. While a thorough examination of the scalp, skin, mucosa, and nails is integral to establishing a diagnosis, certain conditions will resolve only with dialysis or improvement of their renal disease and others may not require or respond to treatment. Half and half nails, pruritus, xerosis, and cutaneous hyperpigmentation are common manifestations in ESRD. Read More

Cutan Ocul Toxicol 2012 Dec 15;31(4):286-91. Epub 2012 Feb 15.

Department of Dermatology, Yenisehir State Hospital, Kahramanmaras, Turkey.

Context: A number of skin diseases can be observed in chronic renal failure (CRF). Their incidence have changed in different series.

Objective: To compare the prevalence of cutaneous changes in CRF undergoing hemodialysis (HD) with healthy persons and to study the potential relationship with various parameters in the patients. Read More

Eur J Dermatol 2012 Jan-Feb;22(1):137-8

Tunis Med 2011 Oct;89(10):799-800

Arch Dermatol 2011 Jun;147(6):747-8

An Bras Dermatol 2011 Mar-Apr;86(2):383-5

Departamento de Dermatologia e Radioterapia, Faculdade de Medicina, Universidade Paulista Julio de Mesquita Filho, Botucatu, SP, Brasil.

Pseudoporphyria is a rare bullous dermatosis that clinically and histopathologically is similar to porphyria cutanea tarda. It mainly affects patients with chronic renal failure on peritoneal dialysis or hemodialysis. Medications can also be involved in the etiology. Read More

Saudi J Kidney Dis Transpl 2011 Mar;22(2):311-4

Service of Nephrology, Haemodialysis and Kidney Transplantation, Military Hospital, Mohammed V, Rabat, Morocco.

We report a 33-year-old female patient who had hemodialysis-associated pseudoporphyria which did not respond to treatment with oral N-acetylcysteine. She responded favorably to treatment with the anti-malarial drug, chloroquine. The case is being reported to highlight the difficulty in interpreting the urinary porphyrin assays in patients on hemodialysis. Read More

Dermatol Online J 2011 Feb 15;17(2):15. Epub 2011 Feb 15.

Voriconazole is an extended-spectrum triazole antifungal approved for treatment of invasive fungal infections. The drug has been associated with phototoxicity, presenting as photodistributed eruptions such as macular erythema or pseudoporphyria. We describe a 59-year-old man with acute myeloid leukemia, status-post matched unrelated donor stem cell transplant, who developed fungal pneumonia and was placed on posaconazole. Read More

Kidney Int 2011 Jan;79(1):140

Department of Clinical Medicine, Federal University of Rio Grande do Norte, Hospital Universitário Onofre Lopes, Natal, Brazil.

NDT Plus 2010 Dec 24;3(6):592-3. Epub 2010 Aug 24.

Department of Nephrology , Chang Gung Memorial Hospital , Taipei , Taiwan ; College of Medicine , Chang Gung University , Taoyuan , Taiwan.

J Am Acad Dermatol 2010 Jul;63(1):e14-6

Arch Dermatol 2010 Mar 18;146(3):300-4. Epub 2010 Jan 18.

Department of Dermatology, University of California-San Francisco, 1701 Divisadero St., San Francisco, CA 94143, USA.

Background: Voriconazole is a triazole antifungal agent approved by the US Food and Drug Administration for serious fungal infections, including with Aspergillus, Fusarium, Pseudallescheria, and Scedosporium species. In initial clinical trials, approximately 2% of patients developed cutaneous reactions, including photosensitivity, cheilitis, and xerosis. Subsequent reports have implicated voriconazole as a cause of severe photosensitivity and accelerated photoaging, pseudoporphyria cutanea tarda, and aggressive squamous cell carcinoma. Read More