{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T15:44:33Z","timestamp":1784821473437,"version":"3.55.0"},"reference-count":13,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T00:00:00Z","timestamp":1777766400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,3]],"date-time":"2026-05-03T00:00:00Z","timestamp":1777766400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>A 50\u2010year\u2010old female patient was referred to our department for consultation regarding perioperative management of breast cancer surgery. She had a history of photosensitivity since childhood and was diagnosed with erythropoietic protoporphyria (EPP) during her first pregnancy. Because EPP is classified as a cutaneous porphyria that can cause hemolysis and liver impairment upon light exposure, we conducted a light\u2010induced hemolysis test to determine intraoperative and postoperative exposure thresholds. Hemolysis was observed after 4\u2009h of surgical light exposure. To minimize light\u2010induced hemolysis during surgery, we applied optical films blocking light around the 400\u2009nm wavelength range to the shadowless operating light, monitors, and overhead lamps. Under these conditions, a four\u2010hour surgical procedure was successfully completed. No liver dysfunction or elevation of plasma protoporphyrin levels was observed intraoperatively or postoperatively. This case provided practical guidance for perioperative light management in EPP.<\/jats:p>","DOI":"10.1111\/1346-8138.70269","type":"journal-article","created":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T06:38:22Z","timestamp":1777876702000},"page":"930-933","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Erythropoietic Protoporphyria and Surgery: A Case of Successful Mastectomy With Perioperative Light Shielding Strategies Based on Light\u2010Induced Hemolytic Threshold Assessment"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6023-5598","authenticated-orcid":false,"given":"Fumika","family":"Tateishi","sequence":"first","affiliation":[{"name":"Department of Dermatology and Allergology Nagasaki University Hospital  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoya","family":"Murayama","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology Nagasaki University Hospital  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruri","family":"Nakamuta","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology Nagasaki University Hospital  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahisa","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Watanabe Dermatology Clinic  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aya","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Department of Surgery, Breast and Endocrine Surgery Nagasaki University Hospital  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0450-1377","authenticated-orcid":false,"given":"Hiroyuki","family":"Murota","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergology Nagasaki University Hospital  Nagasaki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,5,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1608634"},{"key":"e_1_2_6_3_1","first-page":"683","article-title":"A Case of Erythropoietic Protoporphyria Diagnosed by Erythrocyte Photohemolysis and Erythrocyte Fluorescence Test","volume":"4","author":"Fujigami T.","year":"2020","journal-title":"Clin Lab Test Jpn J Med Technol"},{"key":"e_1_2_6_4_1","first-page":"1491","article-title":"A Case of Acute Appendicitis With Erythropoietic Protoporphyria in Which Elective Surgery Was Performed Using a Special Film","volume":"8","author":"Takasu C.","year":"2022","journal-title":"Journal of the Japan Surgical Association"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12328-014-0501-7"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s005350050284"},{"key":"e_1_2_6_7_1","first-page":"124","volume-title":"Clinical Photodermatology","author":"Nishikori C.","year":"2021"},{"key":"e_1_2_6_8_1","first-page":"1","article-title":"Erythropoietic Protoporphyria: Pathogenesis, Clinical Presentation, and Management","volume":"97","author":"Minder A. 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