Mantoux F, Bahadoran P, Perrin C, Bermon C, Lacour J P, Ortonne J P
Service de Dermatologie, Hôpital L'Archet 2, Nice.
Ann Dermatol Venereol. 1999 Feb;126(2):150-2.
Pseudoporphyria is a condition characterized by clinical and histological changes resembling porphyria cutanea tarda, in the absence of any demonstrable abnormality in porphyrin metabolism. Etiologies of pseudoporphyria are hemodialysis for chronic renal failure, chronic UV irradiation, and several drugs, particularly naproxen. We report a case of flutamide induced pseudoporphyria.
A 75-year-old man had prostatic carcinoma and was treated with flutamide for 1-1/2 years. He presented with a several months history of blisters on the back of the hands and fingers, occurring after sun exposures. The bullae were associated with skin fragility and atrophic scarring. Histopathological examination and direct immunofluorescence showed ultrastructural features close to those described in porphyria cutanea tarda. Quantitative analysis of porphyrins in urine and laboratory blood tests were normal. Flutamide was stopped, leading to healing of the lesions, with no relapse after 11 months.
Flutamide is an antiandrogen used for the treatment of prostatic carcinoma. Its principal side-effect is represented by liver toxicity. Cutaneous side-effects of flutamide are uncommon; three cases of photo-allergic dermatitis have been described, and we report with our observation, the third case of cutaneous pseudoporphyria induced by flutamide.
假性卟啉病是一种临床表现和组织学变化类似于迟发性皮肤卟啉病，但卟啉代谢无任何可证实异常的病症。假性卟啉病的病因包括慢性肾衰竭的血液透析、慢性紫外线照射以及几种药物，尤其是萘普生。我们报告一例氟他胺诱发的假性卟啉病病例。
一名75岁男性患有前列腺癌，接受氟他胺治疗1年半。他出现手背和手指水疱数月，日晒后发作。水疱与皮肤脆性和萎缩性瘢痕形成有关。组织病理学检查和直接免疫荧光显示超微结构特征与迟发性皮肤卟啉病中描述的相似。尿卟啉定量分析和实验室血液检查均正常。停用氟他胺后，皮损愈合，11个月后未复发。
氟他胺是一种用于治疗前列腺癌的抗雄激素药物。其主要副作用表现为肝毒性。氟他胺的皮肤副作用并不常见；已描述了3例光过敏性皮炎病例，我们通过观察报告了第3例由氟他胺诱发的皮肤假性卟啉病病例。
