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Pseudoporphyria in Child
See also in: External and Internal Eye
Other Resources UpToDate PubMed

Pseudoporphyria in Child

See also in: External and Internal Eye
Contributors: Jeffrey M. Cohen MD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Pseudoporphyria is a photodistributed blistering eruption with clinical and histologic features similar to porphyria cutanea tarda (PCT), but there are no porphyrin abnormalities in the plasma, urine, or stool.

While commonly associated with NSAIDs, antibiotics, and diuretics with sulfa moieties, pseudoporphyria can also be seen in chronic renal failure (with or without hemodialysis) and with ultraviolet A (UVA) exposure such as tanning beds, psoralen plus UVA (PUVA) therapy, and excessive natural sun. Pseudoporphyria has also been reported in patients taking over-the-counter chlorophyll-containing supplements. Patients may be reluctant to admit to supplement use unless asked directly about green liquid supplements, green smoothie drinks or green superfoods, or chlorophyll specifically.

Codes

ICD10CM:
E80.20 – Unspecified porphyria

SNOMEDCT:
95565000 – Pseudoporphyria

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Porphyria cutanea tarda (PCT) and other porphyrias have associated plasma, stool, and/or urine porphyrin abnormalities. PCT has hypertrichosis, hyperpigmentation, sclerodermoid change, and dystrophic calcification, all of which are rare in pseudoporphyria.
  • Variegate porphyria (VP) – May present with skin findings identical to PCT, but patients are also at risk for acute porphyric neurologic crises (not seen in PCT). Unlike patients with pseudoporphyria, patients with VP may have plasma, stool, and/or urine porphyrin abnormalities.
  • Hepatoerythropoietic porphyria – Rare autosomal recessive uroporphyrin decarboxylase deficiency with childhood onset. Patients may have plasma, stool, and/or urine porphyrin abnormalities.
  • Hereditary coproporphyria
  • Hydroa vacciniforme
  • Bullous Systemic lupus erythematosus
  • Drug-induced photosensitive reaction
  • Epidermolysis bullosa simplex
  • Epidermolysis bullosa acquisita
  • Acute Dermatomyositis
  • Polymorphous light eruption
  • Morphea
  • Allergic contact dermatitis
  • Bullous pemphigoid
  • Bullous Fixed drug eruption
  • Bullous Arthropod bite or sting
  • Bullous amyloidosis (see AL amyloidosis)

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed:12/26/2018
Last Updated:06/30/2022
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Pseudoporphyria in Child
See also in: External and Internal Eye
A medical illustration showing key findings of Pseudoporphyria : Bilateral distribution, Flaccid bullae, Tense bullae, Atrophic scar, Sun-exposed distribution, Tense vesicles
Clinical image of Pseudoporphyria - imageId=112640. Click to open in gallery.  caption: 'A large, flaccid bulla with a purulent erosion on the heel.'
A large, flaccid bulla with a purulent erosion on the heel.
Copyright © 2024 VisualDx®. All rights reserved.