HPI: This 50 year-old man reports he has had "blisters and sores" on dorsum of hands, arms, elbows, and scalp for six months. He feels he is in otherwise good health, takes no meds by mouth and drinks 2 - 3 beers per day. This man works outdoors as a carpenter so he gets lots of sun (although it is winter here). When he developed his initial lesions it was summertime.
O/E: There are superficial erosions of the hands, elbows, and scalp. No vesicles were noted.
Lab: CBC normal
Chemistries: SGOT 141 (normal 10 - 42)
SGPT 164 (normal 19 - 49)
Ferritin 486 (normal 220 - 250
Uroporphyrin: 1523 (normal < 22)
Coprophyrin: 450 (23 - 230)
Total Porphyrins 2675 (normal 31 - 139)
Hepatitis Serology and HIV tests willbe ordered.
Diagnosis: Porphyria Cutanea Tarda
Plan: Will probably treat with hydroxychloroquine
Hepatitis C, porphyria cutanea tarda and liver iron: an update.