PHOTOSENSITIVE BULLOUS ERUPTION ASSOCIATED WITH CHRONIC RENAL FAILURE*

Abstract

SummaryEight patients with chronic renal failure developed blisters similar to those seen in porphyria cutanea tarda. However, porphyrin studies were normal and neither scarring nor milia were seen in these patients. Blistering appeared to be induced by minor trauma to light exposed areas on the dorsa of the hands and feet, and intensity of sunlight seemed more related to blister production than either the type or severity of renal disease or the patient's medication. The blisters were produced by a split at the dermo‐epidermal junction just above the PAS basement membrane zone. The upper dermal blood vessels within the region were thickened by the accumulation of PAS positive material. Although there was little cellular infiltrate, many degranulated mast cells were present in the mid‐dermis. Deviating calciphylaxis may have been associated with these changes.