66-Year-Old Woman With Painless Vesicular Lesions

July 2009 in “ Mayo Clinic Proceedings ”

Aditya Bardia, Elizabeth A. Swanson, Kris G. Thomas

porphyria cutanea tarda PCT hereditary hemochromatosis phlebotomy urinary porphyrins urinary PBG liver abnormalities topical sunscreens estrogens iron supplements sunscreens

TLDR A 66-year-old woman with skin lesions and other symptoms improved after treatment for porphyria cutanea tarda.

A 66-year-old woman with painless vesicular lesions, red-tinged urine, and excessive facial hair growth was diagnosed with porphyria cutanea tarda (PCT) after elevated urinary porphyrins and normal urinary PBG levels were found. Her condition was linked to hereditary hemochromatosis and liver abnormalities. Treatment with phlebotomy significantly improved her symptoms and liver enzyme levels. Long-term management included avoiding alcohol, estrogens, and iron supplements, and using topical sunscreens to prevent exacerbations.

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