This is a bullous dermatosis which is also known as drug-induced porphyria or therapy induced bullous photosensitivity. There are many drugs which have been implicated, many are listed below. In addition to drugs, there have been cases associated with chronic renal failure patients undergoing hemodialysis.
Penicillin and derivatives
Pyridoxine (Vitamin B6)
Harrison's Principles of Internal Medicine. 14th Edition. 1998.
Unlike cases of porphyria, there are no laboratory abnormalities. The clinical lesions resemble porphyria cutanea tarda with spontaneous blisters and skin fragility, usually on the dorsum of the hands. Lesions may develop from 1 week to several months after the start of the drugs. There usually is no hypertrichosis, hyperpigmentation, or sclerodermoid changes.
The microscopic changes are similar to that seen in porphyria cutanea tarda.
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