DAMAGE TO the liver with impairment of hepatic uroporphyrinogen decarboxylase can lead to the development of sporadic porphyria cutanea tarda (PCT).1 In older studies, agents most commonly implicated in the induction of PCT included alcohol, estrogens, iron, polychlorinated hydrocarbons, and hepatitis B virus. Recently, however, PCT has been frequently associated with infections by other viruses, namely, hepatitis C virus (HCV)2-5 and human immunodeficiency virus (HIV).6-9 Two studies in this issue of Archives examine these associations in more detail.10,11 The purposes of this editorial are to review recent information on this topic and to provide practical guidelines to dermatologists on the evaluation for underlying HCV and HIV infection in patients with photosensitivity or overt PCT.
Screening measures to detect hepatitis A and B viruses in the blood supply were developed in the early 1970s, and soon thereafter it became surprisingly clearthat most cases of transfusion-associated hepatitis were not due to these viruses, but to another agent,
Andrew Blauvelt. Hepatitis C Virus and Human Immunodeficiency Virus Infection Can Alter Porphyrin Metabolism and Lead to Porphyria Cutanea Tarda. Arch Dermatol. 1996;132(12):1503–1504. doi:10.1001/archderm.1996.03890360095016