Drug therapy in the acute porphyrias

The thrust of this chapter will be on drug therapy in the acute porphyrias. Specifically, avoidance of those drugs that might precipitate an acute neurologic episode or “acute attack” will be discussed. In the realm of the dermatologist, this will apply to patients with one of two disorders: variegate porphyria (South African genetic porphyria, VP) and hereditary coproporphyria (HC). The third of the acute porphyrias, acute intermittent porphyria (AIP), is not associated with skin lesions and such patients are accordingly unlikely to consult a dermatologist. In this chapter, we shall neither deal with the important topic of drug therapy during an acute attack nor precipitation or treatment by drugs of the purely cutaneous porphyrias; these subjects will be addressed elsewhere in this volume.