We were interested that the report by Roberts and Matthews-Roth1 in the October 1993 issue of the Archives suggested that cysteine (500 mg twice daily) ameliorates both objective and subjective photosensitivity in erythropoietic protoporphyria (EPP). In contrast, a separate double-blind crossover study of N-acetylcysteine (1800 mg/d) in six patients failed to demonstrate improvement in phototests or clinical light sensitivity.2
We have also recently examined the efficacy of N-acetylcysteine in the treatment of patients with EPP attending St John's Institute of Dermatology, St Thomas Hospital, London, England. Local ethics committee approval was obtained as well as informed consent from each patient. Fifteen patients (age, 12 to 68 years) were randomly allocated in double-blind fashion to a placebo-controlled, crossover 4-week study of N-acetylcysteine (600 mg three times daily). Subjects had not received β-carotene for at least 3 weeks before admission into the study. A 1-week washout period followed the
Norris PG, Baker CS, Roberts JE, Hawk JLM. Treatment of Erythropoietic Protoporphyria With N-Acetylcysteine. Arch Dermatol. 1995;131(3):354–355. doi:10.1001/archderm.1995.01690150120026
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