Special considerations for porphyria cutanea tarda include which of the following?

Special considerations for porphyria cutanea tarda include which of the following?

• A. Avoidance of regional techniques because of neurotoxicity
• B. Avoidance of sodium pentothal
• C. Need for higher doses of nondepolarizing NMBDs
• D. Special attention to skin pressure

Answer: (D)

Porphyria cutanea tarda makes the skin unusually fragile and sun-sensitive, so even minor trauma can cause blistering and erosions. In the operating room, pressure from position supports, padding, or restraints can injure the skin or trigger bullae. The safest approach is to protect the skin from pressure by using soft, well-distributed padding, avoiding prolonged or excessive contact at pressure points, and handling the skin gently with minimal adhesive trauma. While drug considerations are important in porphyrias, the most critical and immediately actionable point for this condition is guarding the skin against pressure and trauma.

Porphyria cutanea tarda makes the skin unusually fragile and sun-sensitive, so even minor trauma can cause blistering and erosions. In the operating room, pressure from position supports, padding, or restraints can injure the skin or trigger bullae. The safest approach is to protect the skin from pressure by using soft, well-distributed padding, avoiding prolonged or excessive contact at pressure points, and handling the skin gently with minimal adhesive trauma. While drug considerations are important in porphyrias, the most critical and immediately actionable point for this condition is guarding the skin against pressure and trauma.