Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content + Download Section PDF Listen ++ For further information, see CMDT Part 6-23: Porphyria Cutanea Tarda + Key Features Download Section PDF Listen +++ ++ Noninflammatory blisters on sun-exposed sites, usually only the dorsal hands Hypertrichosis, skin fragility Associated liver disease Elevated urine porphyrins The disease is associated with ingestion of certain medications (eg, estrogens), and alcoholic liver disease or hepatitis C + Clinical Findings Download Section PDF Listen +++ ++ Painless blistering and fragility of the skin of the dorsal surfaces of the hands Facial hypertrichosis and hyperpigmentation In patients with liver disease, hemosiderosis is often present Differential diagnosis Pseudoporphyria: dialysis, medications (tetracycline, nonsteroidal anti-inflammatory drugs, voriconazole) Contact dermatitis Scabies + Diagnosis Download Section PDF Listen +++ ++ Urinary uroporphyrins are elevated two- to five-fold above coproporphyrins There may be abnormal liver biochemical tests, evidence of hepatitis C infection, increased liver iron stores, and various hemochromatosis gene mutations + Treatment Download Section PDF Listen +++ ++ Phlebotomy without oral iron supplementation at a rate of 1 unit every 2–4 weeks will gradually lead to improvement Hydroxychloroquine 200 mg orally twice weekly will increase the excretion of porphyrins, improving the skin disease Deferasirox, an iron chelator can also improve porphyria cutanea tarda Stopping all triggering medications and stopping alcohol consumption may lead to improvement Most patients improve with treatment Barrier sun protection with clothing is required for prevention