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Multiple factors, including chronic renal failure, dialysis, excessive sun exposure, PUVA treatment, and treatment with drugs such as NSAIDs, antibiotics, and diuretics are implicated in the development of pseudoporphyria.12,13 Several external factors, including PUVA treatment, have been associated with the development of bullous pemphigoid.1416 PUVA-induced alterations in basement membrane proteins could induce an immune response mediated by autoantibodies that cross react with basement-membrane proteins

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