NAPROXEN-INDUCED PSEUDOPORPHYRIA IN PATIENTS WITH JUVENILE RHEUMATOID-ARTHRITIS

Pseudoporphyria, a cutaneous disorder characterized by skin fragility, vesiculation, and scarring, has been reported as a side effect of nap roxen therapy in children with juvenile rheumatoid arthritis (JRA). We report the results of a 6-month prospective study to determine the pr evalence of pseudoporphyria in our JRA population. All the patients wi th pseudoporphyria had received naproxen for greater than or equal to 4 weeks at the time of the study. Of the patients treated with naproxe n, 12% (9/74) developed this complication. No patient had significant elevation of free erythrocyte protoporphyrin, excluding the diagnosis of true erythropoietic protoporphyria. We conclude that pseudoporphyri a is a common side effect of naproxen therapy in children with JRA, ev en in geographic areas without high sun exposure. Because of the risk of facial scarring with pseudoporphyria, physicians and parents of chi ldren with JRA should be aware of this complication.