Pseudoporphyria in Child
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.
E80.20 – Unspecified porphyria
95565000 – Pseudoporphyria
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 lupus erythematosus
- Drug-induced photosensitive reaction
- Epidermolysis bullosa simplex
- Epidermolysis bullosa acquisita
- Acute dermatomyositis
- Polymorphous light eruption
- Contact dermatitis
- Bullous pemphigoid
- Bullous fixed drug eruption
- Bullous arthropod bites
- Bullous amyloidosis (see AL amyloidosis)
Drug Reaction Data