Porphyria cutanea tarda induced by alcohol abuse: A case report

Porphyrias are group of inherited and acquired disorders resulting from enzyme deficiency in the metabolic pathway of haem biosynthesis. Among all types of porphyria, the most common type is porphyria cutanea tarda in adults, occurring due to deficiency of enzyme uroporphyrinogen decarboxylase in the metabolic pathway ofm heme biosynthesis. A 35-year old man presented in opd with chief complaints of recurrent episodes of vesicles, blisters, erosions, raw areas on dorsum of hand and face for 2 years. Local examination revealed multiple erosions with adherent crusting, atrophic plaques of healed lesions over the face and multiple hyperpigmented macules with scaring, erosion and raw areas present overe dorsum of the hands. Laboratory findings showed abnormal liver profile and elevated zinc protoporphyrin and coprophyrin levels. Urine revealed coral pink fluorescence under woods lamp. Histology of the skin showed epidermal spongiosis, subepidermal blister with minimal inflammatory cell infilterate in the dermis. Treatment given were sun screen lotions, hydroxy-chloroquine, avoidance of triggering factors and alcohol discontinuation. Patient showed marked improvement in skin lesions.