Multiple Skin Ulcers as a Primary Manifestation of Porphyria Cutanea Tarda

Abstract

A case of porphyria cutanea tarda (PCT) with multiple ulcers on the scalp occurring in a 63-year-old man is reported. The first biopsy specimen from the purpura on the scalp revealed no diagnostic findings. We treated him with the standard topical therapy consisting of oral antibiotics, however, painful symptoms continued for another 6 months. 3 months after his first visit, he developed a few small bean sized bulla on the dorsal aspects of the hands. His urinary excretion of uroporphyrin and coproporphyrin was also excessive. The clinical, biochemical and histological features of this case closely match the diagnosis of PCT. We considered that the slow healings observed in this case was due to the fragility of the scalp skin, repeated microtrauma, previously improper treatment and complication due to secondary infections.