Which porphyrias are associated with photodermatoses?

The most common porphyria with prominent cutaneous findings is porphyria cutanea tarda (PCT). There is a delay in the onset of lesions following sun exposure; thus, many PCT patients do not specifically complain of photosensitivity. The cutaneous changes seen in PCT may also be seen in other porphyrias, including variegate porphyria and hereditary coproporphyria; in pseudoporphyrias associated with hemodialysis; and with certain medications, such as furosemide, nalidixic acid, tetracycline, and naproxen (referred to as pseudoporphyria). More acute photosensitivity is seen in erythropoietic protoporphyria, congenital erythropoietic porphyria, and erythropoietic coproporphyria and is manifested by burning and stinging within minutes of exposure, followed by erythema, blistering, and scarring if severe.