Abstract
Background: Pseudoporphyria is a photosensitive bullous skin disease that mimics porphyria cutanea tarda and differs by having normal serum and urine porphyrin. It occurs in sun-exposed skin areas leading to skin fragility and blister formation. It is usually induced by certain medications and can also occur in chronic kidney disease patients on long term dialysis.
Case Report: We report a 66-year-old gentleman with chronic kidney disease on thrice weekly maintenance haemodialysis for last three years, who developed recurrent blister formation on dorsum of both hands over a six-month period. He experienced periodical formation of serous fluid-containing blisters, measuring up to 2 cm in diameter. The blisters usually resolved without any intervention in about three weeks, leaving behind pale and pink skin. The blisters were not associated with pain, pruritus or erythema. Most days, he spent several hours outdoors with exposure to sunlight. Skin biopsy showed marked subepidermal oedema with erythrocyte extravasation and blistering with regeneration of basal keratinocytes. Immunofluorescence was negative, and vasculitis was not evident. The features were most consistent with pseudoporphyria. He was on high dose of furosemide, which was ceased, and his bullous lesions resolved gradually with no further blister formation. Hence, we postulate that his pseudoporphyria was induced by the furosemide in the setting of long term haemodialysis.
Conclusions: Although relatively uncommon, pseudoporphyria remains a differential diagnosis in cutaneous diseases of chronic kidney disease patients on long term dialysis.
Case Report: We report a 66-year-old gentleman with chronic kidney disease on thrice weekly maintenance haemodialysis for last three years, who developed recurrent blister formation on dorsum of both hands over a six-month period. He experienced periodical formation of serous fluid-containing blisters, measuring up to 2 cm in diameter. The blisters usually resolved without any intervention in about three weeks, leaving behind pale and pink skin. The blisters were not associated with pain, pruritus or erythema. Most days, he spent several hours outdoors with exposure to sunlight. Skin biopsy showed marked subepidermal oedema with erythrocyte extravasation and blistering with regeneration of basal keratinocytes. Immunofluorescence was negative, and vasculitis was not evident. The features were most consistent with pseudoporphyria. He was on high dose of furosemide, which was ceased, and his bullous lesions resolved gradually with no further blister formation. Hence, we postulate that his pseudoporphyria was induced by the furosemide in the setting of long term haemodialysis.
Conclusions: Although relatively uncommon, pseudoporphyria remains a differential diagnosis in cutaneous diseases of chronic kidney disease patients on long term dialysis.
| Original language | English |
|---|---|
| Article number | Poster 238 |
| Pages (from-to) | 249 |
| Number of pages | 1 |
| Journal | Nephrology |
| Volume | 21 |
| Issue number | S2 |
| Publication status | Published - Sept 2016 |
| Externally published | Yes |
| Event | Annual Scientific Meeting of the Australian-and-New-Zealand-Society-of-Nephrology 2016 - Western Australia, Perth, Australia Duration: 17 Sept 2016 → 21 Sept 2016 Conference number: 52nd https://onlinelibrary.wiley.com/toc/14401797/2016/21/S2 (Nephrology, Vol 21, Issue S2) |
Cite this
- APA
- Author
- BIBTEX
- Harvard
- Standard
- RIS
- Vancouver