The June issue of the ARCHIVES features a "Pathologic Case of the Month" on erythropoietic protoporphyria and outlines the progressive damage that can be caused by an overabundance of type IV collagen.1 Repeated episodes lead to fibrogenic changes in the skin and, sometimes, to cirrhosis in the liver. I would like to ask whether this disease is mostly inflammation involving primarily the fibrosis limb of inflammation?