{ "schema_version": 1, "kind": "condition", "id": "porphyria", "name": "Porphyria", "category": "chronic", "sources": "ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class TD99.07 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Porphyria Cutanea Tarda - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK563209/ · Zinc oxide sunscreen US OTC label, Directions (DailyMed SetID 005d0245-fe53-47e5-888b-683f58cd6d26)", "review_status": "reviewed", "verified_against": "No dose - referral pathway, no medicine given in primary care · Porphyria - disease-level clinical article (porphyria-clinical.txt)", "verified_date": "2026-08", "treatments": [ { "id": 1440, "generic": "No drug therapy in primary care (Referral & Advice)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": "A rare inherited metabolic disease; the GP's role is to recognise characteristic attacks (abdominal pain, neuropsychiatric symptoms, photosensitive skin lesions) and refer for specialist diagnosis and management, including avoiding drugs known to trigger attacks.", "adult_duration": "Refer, with advice", "dose_source": "No dose - referral pathway, no medicine given in primary care", "rationale": "A rare inherited metabolic disease; the GP's role is to recognise characteristic attacks (abdominal pain, neuropsychiatric symptoms, photosensitive skin lesions) and refer for specialist diagnosis and management, including avoiding drugs known to trigger attacks.", "cautions": [ "An acute porphyric attack with severe abdominal pain, seizures, or neuropsychiatric change is a medical emergency; certain common drugs can precipitate attacks and must be avoided.", "Rare in Egyptian primary care.", "No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.", "RED FLAG - PCT independently increases the risk for liver cirrhosis and hepatocellular carcinoma, accentuated by coexisting HCV infection, alcoholic hepatitis, or iron overload.", "RED FLAG - Neurovisceral symptoms (abdominal pain, neuropsychiatric symptoms) distinguish acute porphyrias (variegate porphyria, hereditary coproporphyria) from PCT, where neurovisceral symptoms are absent." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Children follow the same pathway: recognise and refer. No primary-care medicine is implied.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "porphyria" }, { "id": 1441, "generic": "Zinc oxide", "line": 1, "is_adjunct": true, "form": "topical", "strength_mg": null, "adult_dose": "Apply a mineral sunscreen liberally to exposed skin 15 minutes before going out, and again at least every 2 hours", "adult_duration": "Every day the patient goes out in daylight, for as long as the skin disease is active", "dose_source": "Zinc oxide sunscreen US OTC label, Directions (DailyMed SetID 005d0245-fe53-47e5-888b-683f58cd6d26) - verbatim: \"Apply liberally 15 minutes before sun exposure and as needed. Children under 6 months of age: ask a doctor. Reapply at least every 2 hours\"", "rationale": "Porphyria cutanea tarda blisters in visible violet light at 400 to 410 nm, which ordinary chemical sunscreens do not filter - only a zinc oxide or titanium dioxide mineral block does. In Cairo sunshine this is the single most useful thing a GP can hand the patient while the specialist referral is arranged.", "cautions": [ "Check the ingredient list - a sunscreen whose only filters are avobenzone, oxybenzone or octocrylene will not protect this patient; the label must name zinc oxide or titanium dioxide.", "Sunscreen alone is not enough: long sleeves, a hat and staying out of the sun between 10 a.m. and 2 p.m. matter as much.", "This is protective, not curative - phlebotomy or hydroxychloroquine is decided by the service the patient is referred to, and alcohol, smoking, oestrogen and iron still have to be avoided." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Ask a doctor before using sunscreen on a child under 6 months. Older children with a photosensitive porphyria use the same mineral products, applied the same way.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "NAPI-CARE OINT.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ARAB DRUG COMPANY (ADCO)", "price_egp": 2.35, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "PENTADIAPER 20% TOPICAL CREAM 30 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA > PENTA PHARMA", "price_egp": 3.5, "pack_count": null, "unit_price": null, "strength_mg": 30000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BABY RASH FREE 30% OINT.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ALEXANDRIA > MILLENIUM PHARMA-EGYPT", "price_egp": 5.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "EVA BABY CARE CREAM 50 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EVA PHARMA", "price_egp": 9.75, "pack_count": null, "unit_price": null, "strength_mg": 50000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "BALMIX 10% CREAM 30 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "SIGMA", "price_egp": 14.4, "pack_count": null, "unit_price": null, "strength_mg": 30000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NONOPENT CREAM 75 GM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "> PENTA PHARMA", "price_egp": 100.0, "pack_count": null, "unit_price": null, "strength_mg": 75000.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "NINO SERENO CREAM", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE > GMCKS", "price_egp": 120.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "porphyria" } ] }