Cimetidine in the Treatment of Porphyria Cutanea Tarda.

Horie, Yutaka; Tanaka, Keiko; Okano, Jun-ichi; Ohgi, Nagako; Kawasaki, Hironaka; Yamamoto, Shin‐Ichi; Kondo, Masao; Sassa, Shigeru

doi:10.2169/internalmedicine.35.717

Cited by 18 publications

(13 citation statements)

References 11 publications

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“…Antihistamines are proven to have a role in symptom relief in some fibrotic disorders as porphyria cutanea tarda,[31] scleroderma and keloids. [32] In addition, cromolyn sodium, a mast cell stabilizer, is the only FDA approved medicine for treatment of mastocytosis.…”

Section: Discussionmentioning

confidence: 99%

Skin tags: A link between lesional mast cell count/tryptase expression and obesity and dyslipidemia

Salem¹,

Attia

Osman³

et al. 2013

Indian J Dermatol

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Background:The etiology of skin tags (STs) is not fully understood. A relation to diabetes mellitus and obesity was suggested. Few studies of possible mast cells (MCs) involvement were reported. Tyrptase is a mast cell mediator and a potent fibroblast growth factor. It may provide a molecular link between mast cell activation and fibrosis.Aims:The aim was to assess clinical and laboratory findings in patients with STs, and the possible link between obesity, dyslipidemia, and lesional MC count/tryptase expression.Materials and Methods:A total of 20 patients with STs were subjected to clinical examination, estimation of body mass index (BMI), fasting blood glucose (FBG), postprandial blood glucose (PPBG), serum cholesterol and triglycerides, abdominal ultrasound for fatty liver assessment, in addition to study of MCs through staining for MC tryptase in two skin biopsies; lesional and nonlesional (control).Results:All patients showed abnormally high BMI and hypertriglyceridemia, with abnormal sonographic pattern in 15 patients (75%). STs number positively correlated with the age of patients. STs showed significantly higher MC counts and tryptase expression, compared with control skin (P < 0.001), with no correlation of the STs number or MC count with BMI, FBG, PPBG or serum cholesterol. Obese patients showed a significantly higher MC count than overweight and there was a positive correlation between MC count and serum triglycerides. Axilla and under breast STs showed a higher MC count compared with other sites.Conclusions:STs seem to be related to obesity and hypertriglyceridemia. MCs with their tryptase are possibly involved in pathogenesis of STs. MC count is related to the associated factors; obesity and serum triglycerides. MC tryptase expression is a reliable method for accurate tissue MC counting.

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Section: Discussionmentioning

confidence: 99%

Skin tags: A link between lesional mast cell count/tryptase expression and obesity and dyslipidemia

Salem¹,

Attia

Osman³

et al. 2013

Indian J Dermatol

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“…Cimetidine, which has had some efficacy in acute intermittent porphyria (AIP) and EPP (see Erythropoietic porphyrias, Additional treatments), was reported to have improved skin lesions and decreased urinary porphyrins in one patient with PCT, although its administration coincided with the patient's stopping of alcohol ingestion. 91 Its mechanism of action in PCT is unclear. 91 Vitamin E/tocopherol acetate It has been postulated that increased oxidative stress plays a major role in PCT, and there are several reports of the use of vitamin E as adjunctive therapy in patients with PCT.…”

Section: Hemochromatosis and Pctmentioning

confidence: 99%

“…91 Its mechanism of action in PCT is unclear. 91 Vitamin E/tocopherol acetate It has been postulated that increased oxidative stress plays a major role in PCT, and there are several reports of the use of vitamin E as adjunctive therapy in patients with PCT. The therapeutic response of PCT to vitamin E was reported as early as 1969, 92 since then additional reports have been published.…”

Section: Hemochromatosis and Pctmentioning

confidence: 99%

Cutaneous porphyrias part II: treatment strategies

et al. 2013

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The porphyrias are diverse in pathophysiology, clinical presentation, severity, and prognosis, presenting a diagnostic and therapeutic challenge. Although not easily curable, the dermatological manifestations of these diseases, photosensitivity and associated cutaneous pathology, can be effectively prevented and managed. Sun avoidance is essential, and patient education regarding the irreversibility of photocutaneous damage is a necessary corollary. Beyond preventative measures, the care of fragile, vulnerable skin, and pain management, each of the porphyrias has a limited number of unique additional therapeutic options. Many of the treatments have been published only in small case series or anecdotal reports and do not have well-understood nor proven mechanisms of action. This article presents a comprehensive review of available therapeutic options and long-term management recommendations for the cutaneous porphyrias.

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“…Such an induction has not been seen in PCT, but the enzyme inhibitor cimetidine improved PCT in a single case [53]. IFN-α is used in hepatitis C infection.…”

Section: Other Pharmacological Treatmentsmentioning

confidence: 99%

Therapy of porphyria cutanea tarda

Köstler¹,

Wollina²

2005

Expert Opinion on Pharmacotherapy

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Porphyria cutanea tarda (PCT) is the most common type of porphyria. There is an association of PCT with haemochromatosis, diabetes mellitus and hepatitis C infection. The basis of treatment of PCT consists of three elements: avoidance of triggering factors, iron depletion and porphyrin elimination. Alcohol and certain systemic medical drugs, such as oestrogens (or tuberculostatics), should be considered as triggering factors, and as far as possible, avoided. Other triggering factors, such as chronic haemodialysis in renal insufficiency, need a different approach. The hallmark in iron depletion is phlebotomy. Porphyrin elimination is achieved using low-dose chloroquin therapy. The treatment is safe and effective but has its limits in cases with haemochromatosis (HFE) gene mutations. Here iron depletion needs additional phlebotomy. In patients with chronic haemodialysis-associated PCT, chloroquine is ineffective. Erythropoietin, desferroxamine and small-volume phlebotomy have been employed to control the disease. Childhood PCT is very rare. No controlled studies are available, but published experience suggests that body weight-adapted chloroquine therapy or small volume phlebotomy might be useful.

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Cimetidine in the Treatment of Porphyria Cutanea Tarda.

Cited by 18 publications

References 11 publications

Skin tags: A link between lesional mast cell count/tryptase expression and obesity and dyslipidemia

Skin tags: A link between lesional mast cell count/tryptase expression and obesity and dyslipidemia

Cutaneous porphyrias part II: treatment strategies

Therapy of porphyria cutanea tarda

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