Chloroquine in the treatment of porphyria cutanea tarda

Porphyria cutanea tarda (PCT) is common in Ethiopia and invariably affects the liver. Treatment by abstension from alcohol and avoidance of direct sunlight often failed to achieve lasting improvement. Phlebotomy is unacceptable to most of our patients and impractical as a routine therapy. Chloroquine phosphate 500 mg (300 mg base) given daily for 10 days to 24 patients with confirmed PCT, was found to be uniformly effective. Both clinical and biochemical remissions were complete, The side effects of chloroquine include fever, nausea, vomiting and myalgia which predictably occur on the third day of therapy and subside within 72 hours. Since all other modes of therapy are ineffective or impractical and since the response to chloroquine is prompt, effective and reproducible and the side effects are brief, mild and do not cause permanent hepatic damage, it is suggested that this drug is currently the most practical treatment for PCT in areas where repeated phlebotomy is unacceptable and patient follow-up is unsatisfactory.