The dermatologic
manifestations of porphyrias result from localized cutaneous formation of
reactive oxygen species. The significance of these inflammatory mediators may
extend beyond the skin, as increased oxidative stress may play a role in the
systemic manifestations of porphyrias. Polypodium
leucotomos is a tropical fern that has demonstrated antioxidant,
anti-inflammatory and photoprotective properties. Although it has proven
effective in the treatment of various photoaggravated dermatoses, we are unaware
of any prior reports citing Polypodium
leucotomos as a beneficial treatment option in the setting of porphyria
cutanea tarda. We describe a patient with refractory porphyria cutanea tarda,
who demonstrated dramatic improvement in cutaneous lesions following the
initiation of Polypodium leucotomos extract. Due to its low toxicity and demonstrated direct interference in the
production of inflammatory mediators are
central to cutaneous manifestations of porphyrias,
we propose consideration of Polypodium
leucotomos as a potential therapeutic option for patients with porphyria
cutanea tarda.
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