Porphyria cutanea tarda in a haemodialysed patient

A bullous dermatosis, that arose about 2 years after the beginning of haemodialysis treatment, was due to a geniune hereditary porphyria cutanea tarda (PCT). The plasma porphyrins were extraordinarily high. Neither the residual renal function nor the haemodialysis--using different techniques and different materials--succeeded in reducing the plasma porphyrin levels to that usually found in PCT. The serious and rapid evolution of the cutaneous lesions towards a scleroderma-like state might have been due to this level of plasma porphyrins and to their passage into the tissues. The clearance of porphyrins is compared with that of 162 subjects affected by PCT. The porphyrin content in the plasma of seventy-five non-porphyric subjects undergoing maintenance dialysis was also studied.