66-Year-Old Woman With Painless Vesicular Lesions

    June 2009 in “ Mayo Clinic Proceedings ”
    Aditya Bardia, Elizabeth A. Swanson, Kris G. Thomas
    TLDR A woman was diagnosed with porphyria cutanea tarda and improved with phlebotomy and lifestyle changes.
    A 66-year-old woman with painless vesicular lesions was diagnosed with porphyria cutanea tarda (PCT), linked to elevated urinary porphyrins and hereditary hemochromatosis. Her treatment with phlebotomy led to significant symptom improvement. Long-term management included avoiding iron supplementation, NSAIDs, and sun exposure. PCT, caused by a deficiency in the UROD enzyme, can be sporadic or familial, with risk factors like alcohol, estrogen, hemochromatosis, and hepatitis C. Diagnosis involves urinary porphyrin evaluation, and treatment typically includes phlebotomy, with alternatives like iron chelation or low-dose chloroquine when necessary.
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