Porphyria cutanea tarda triggered by hepatitis-E virus.

Area of Science:

• Hepatology
• Dermatology
• Genetics

Background:

• Porphyria cutanea tarda (PCT) is the most prevalent chronic porphyria, often linked to hepatitis C virus (HCV), lymphoma, and iron overload.
• Current understanding of PCT etiology primarily associates it with factors like HCV and iron overload.

Observation:

• A unique case of PCT is presented, manifesting with skin fragility, hemorrhagic bullous exanthema, and onycholysis.
• The patient's PCT onset occurred subsequent to a hepatitis E virus (HEV) infection.

Findings:

• Hepatitis E virus (HEV) infection was identified as the likely trigger for PCT in a genetically predisposed individual.
• The patient responded successfully to treatment with erythrocytapheresis and hydroxychloroquine.
• Erythrocytapheresis proved to be a viable alternative to traditional phlebotomy for managing PCT.

Implications:

• This case suggests HEV infection should be considered in the differential diagnosis of PCT.
• Erythrocytapheresis is presented as a promising therapeutic option for PCT management.
• The study expands the known etiological factors associated with porphyria cutanea tarda.