Association Between Porphyria Cutanea Tarda and Human Immunodeficiency Virus Infection

To the Editor.—  We have read with interest the excellent articles by Strauss¹ and Cockerell² regarding the endocrine and cutaneous manifestations of acquired immunodeficiency syndrome. In neither of these articles is anything mentioned about porphyria cutanea tarda (PCT), a metabolic illness with prominent cutaneous manifestations associated with infection with human immunodeficiency virus (HIV). We have had the opportunity to treat a patient in whom PCT was diagnosed.

Report of a case.—  A 44-year-old man, who had occasionally used intravenous drugs and drank 100 g of alcohol per day, sought medical attention because of cutaneous lesions on the forehand, photosensitivity, and increased fragility to trauma, which appeared in the last few months. He also had a discrete elevation of transaminase levels. Twenty-four-hour urine coproporphyrin and uroporphyrin levels were elevated (509 ug/24 h and 1029 μg/24 h, respectively). Porphyria cutanea tarda was diagnosed, and periodical phlebotomies were begun, which effected