To the Editor.—
Porphyria cutanea tarda (PCT) is a disorder with multiple causes, and the liver appears to be the main target organ that regulates the breakdown metabolism of heme. Unfortunately, not all the proven causes are well known, and I was surprised at a recent meeting to hear a well-known expert on porphyrins give only a partial list of causes. They include the following: (1) alcoholism1; (2) estrogen and oral contraceptives2-4; (3) iron overload1; (4) alcoholism and iron overload1; (5) chemicals such as hexachlorobenzene, corticosteroids, and pentachlorophenol1,5; (6) viral hepatitis1; (7) hepatic porphyrinoma (a liver tumor that produces porphyrins)6; (8) hematologic conditions such as polycythemia vera and disorders that require multiple transfusions (ie, iron overload)7; (9) Felty syndrome in a woman with hypersplenism; and (10) cirrhosis following an ileo cecal shunt for weight reduction (personal observation). The association of lupus erythematosus
Reed WB. Causes of Porphyria Cutanea Tarda. Arch Dermatol. 1977;113(2):235. doi:10.1001/archderm.1977.01640020107024
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