Protoporphyrin IX-induced phototoxicity: Mechanisms and therapeutics

Zahir Hussain, Qian Qi, Junjie Zhu, Karl E. Anderson, Xiaochao Ma

Research output: Contribution to journalReview articlepeer-review

5 Scopus citations


Protoporphyrin IX (PPIX) is an intermediate in the heme biosynthesis pathway. Abnormal accumulation of PPIX due to certain pathological conditions such as erythropoietic protoporphyria and X-linked protoporphyria causes painful phototoxic reactions of the skin, which can significantly impact daily life. Endothelial cells in the skin have been proposed as the primary target for PPIX-induced phototoxicity through light-triggered generation of reactive oxygen species. Current approaches for the management of PPIX-induced phototoxicity include opaque clothing, sunscreens, phototherapy, blood therapy, antioxidants, bone marrow transplantation, and drugs that increase skin pigmentation. In this review, we discuss the present understanding of PPIX-induced phototoxicity including PPIX production and disposition, conditions that lead to PPIX accumulation, symptoms and individual differences, mechanisms, and therapeutics.

Original languageEnglish (US)
Article number108487
JournalPharmacology and Therapeutics
StatePublished - Aug 2023
Externally publishedYes


  • Erythropoietic protoporphyria
  • Heme
  • Phototoxicity
  • Protoporphyrin IX
  • X-linked protoporphyria

ASJC Scopus subject areas

  • Pharmacology
  • Pharmacology (medical)


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