Everything about Erythropoietic Protoporphyria totally explained
Erythropoietic protoporphyria (EPP) is a relatively mild form of
porphyria, although very painful, which arises from a deficiency in the enzyme
ferrochelatase, leading to abnormally high levels of
protoporphyrin in the tissue. The severity varies significantly from individual to individual.
Symptoms and presentation
A common symptom is very painful
photosensitivity, manifesting itself as a burning sensation on the surface of the skin. This usually first presents in childhood, and most often affects the face and the upper surfaces of the hands and feet. Prolonged exposure to the sun can lead to edema and blistering. After many years, chronically sun-exposed skin may become thick and wrinkled. People with EPP are also at increased risk to develop
gallstones. In a small percentage of cases, protoporphyrin accumulates to toxic levels in the liver, leading to liver failure.
Treatment and prognosis
There is no cure for this disorder; however, symptoms can usually be managed by the simple expedient of limiting sun exposure. Protective clothing is also very helpful; however, since the photosensitivity results from light in the visible spectrum, most
sunscreens (with the exception of light-reflecting substances such as
zinc oxide) are of little use. Some individuals can decrease their sun sensitivity with daily doses of
beta carotene; others gradually build a protective layer of
melanin by regularly exposing themselves for short times to ultraviolet radiation. The most severe cases are sometimes treated with liver transplants.
Experimental treatments
In 2007 Australian company Clinuvel Pharmaceuticals Limited began Phase III
clinical trials with a
melanocyte-stimulating hormone called
melanotan which they refer to with the
proprietary name CUV1647 for EPP.
History
Erythropoietic protoporphyria was first identified in 1960 by Magnus
et al at the
St John's Institute of Dermatology in London.
Further Information
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