The Role of Polypodium leucotomos Extract in the Treatment of Porphyria Cutanea Tarda

The dermatologic manifestations of porphyrias result from localized cutaneous formation of reactive oxygen species. The significance of these inflammatory mediators may extend beyond the skin, as increased oxidative stress may play a role in the systemic manifestations of porphyrias. Polypodium leucotomos is a tropical fern that has demonstrated antioxidant, anti-inflammatory and photoprotective properties. Although it has proven effective in the treatment of various photoaggravated dermatoses, we are unaware of any prior reports citing Polypodium leucotomos as a beneficial treatment option in the setting of porphyria cutanea tarda. We describe a patient with refractory porphyria cutanea tarda, who demonstrated dramatic improvement in cutaneous lesions following the initiation of Polypodium leucotomos extract. Due to its low toxicity and demonstrated direct interference in the production of inflammatory mediators are central to cutaneous manifestations of porphyrias, we propose consideration of Polypodium leucotomos as a potential therapeutic option for patients with porphyria cutanea tarda.