Between a Rock and a Hard Place: Management of Systemic Lupus Erythematosus and Porphyria Cutanea Tarda
Journal of Dermatological Treatment
Porphyria cutanea tarda (PCT), the most common porphyria, is a rare photodermatosis characterized by fragile, hemorrhagic bullae and erosions with associated milia, hyperpigmentation, and hypertrichosis. SLE is a systemic connective tissue disease with approximately 80% of those affected manifesting cutaneous findings. These include malar and discoid rashes, photosensitivity, bullae, oral ulcerations, as well as a variety of other nonspecific findings. In this case, we illustrate a rare but established association between these two pathologic entities, and the resulting therapeutic challenge in treating a patient with both conditions. The concurrence of these two diseases poses therapeutic challenges with a paucity of evidence-based recommendations. Management with low dose weekly antimalarial therapy may be the appropriate middle ground in effectively treating the two co-morbid conditions especially in a patient with other underlying systemic conditions.
Systemic lupus erythematosus, antimalarials, bullae, hydroxychloroquine, porphyria cutanea tarda
Nyckowski TA, Grammenos A, Vinokurov A, Nathoo R. Between a Rock and a Hard Place: Management of Systemic Lupus Erythematosus and Porphyria Cutanea Tarda. Journal of Dermatological Treatment. 2022; 33(5). doi: 10.1080/09546634.2022.2060925.