Click here to view. It is most common in men but has become more frequent in women in association with alcohol and Both acquired and inherited factors can play causative roles in porphyria cutanea tarda. The majority of cases are type I, in which uroporphyrinogen decarboxylase mutations are not found and the enzyme is deficient in the liver but not in erythrocytes and other tissues. The amount of hepatic uroporphyrinogen decarboxylase protein, as measured Most patients with porphyria cutanea tarda have a history of moderate or heavy alcohol intake. The disease may develop in men treated with estrogens for prostate cancer and in women taking oral contraceptives or replacement estrogens.
Cutaneous photosensitivity is the major clinical feature.
Vesicles and bullae develop on the face, dorsum of the hands and feet, forearms, and Liver histopathology is not usually diagnostic of alcoholic liver disease. Cirrhosis and hepatocellular carcinomas are most common in older patients and at autopsy. Skin lesions may be more severe and plasma porphyrin levels much higher in this setting because urinary excretion of porphyrins is not possible and they are poorly dialyzed. Very rarely, hepatic tumors themselves contain and presumably produce excess porphyrins. Skin lesions in PCT, VP, and HCP are indistinguishable clinically and histologically.