PMC4763554_01
Hands of a woman with porphyria cutanea tarda (PCT). (a) Before therapy, there were vesicles, bullae with erythematous bases, older lesions in various stages of erosion, resolution, scarring, and punctate milia, all typical of PCT. (b) After iron depletion with phlebotomy, there were no active skin lesions, although hyperpigmentation, scarring, and milia (especially over dorsal aspects of second and third interphalangeal joints) persisted.
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Lesions were most prominent on the dorsal surfaces of the hands and fingers (Fig. 1a).