title: Porphyria cutanea tarda presenting as cicatricial conjunctivitis.
abstract: OBJECTIVE
  To report a case of porphyria cutanea tarda presenting as cicatricial conjunctivitis.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  A 31-year-old man presented with bilateral inferior symblepharon, superior tarsal conjunctival scarring and concretions, and recurrent conjunctival and episcleral injection.
  
  
  RESULTS
  Four years after initial presentation, the patient developed hepatitis C, and 2 years later blisters on his scalp and hands. Direct immunofluorescence studies of biopsies taken from the palpebral conjunctiva of the right lower lid were negative for cicatricial pemphigoid. A twenty-four hour urine specimen analysis revealed elevated levels of uroporphyrins and polycarboxylated porphyrins, confirming the diagnosis of porphyria cutanea tarda. The patient was treated with repeated phlebotomies and oral hydroxychloroquine, which resulted in a significant decrease in the skin lesions, conjunctival injection, and concretions under the upper lids.
  
  
  CONCLUSIONS
  Cicatricial conjunctivitis may be a manifestation of porphyria cutanea tarda.
authors.affiliation: Cornea Service, Wills Eye Hospital, Jefferson Medical College, Philadelphia, Pennsylvania 19107, USA. parkajangyun@yahoo.com
authors.forename: Anna J
authors.initials: AJ
authors.lastname: Park
authors.forename: Guy F
authors.initials: GF
authors.lastname: Webster
authors.forename: Robert B
authors.initials: RB
authors.lastname: Penne
authors.forename: Irving M
authors.initials: IM
authors.lastname: Raber
mesh_terms: D000284:Administration, Oral; D000328:Adult; D002921:Cicatrix / Q000150:complications* / Q000473:pathology; D003231:Conjunctivitis / Q000209:etiology* / Q000473:pathology; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D006886:Hydroxychloroquine / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D018962:Phlebotomy; D017119:Porphyria Cutanea Tarda / Q000150:complications* / Q000175:diagnosis / Q000628:therapy / Q000652:urine; D011166:Porphyrins / Q000652:urine; D012867:Skin / Q000473:pathology; D014578:Uroporphyrins / Q000652:urine
chemical_list: D003879:Dermatologic Agents; D011166:Porphyrins; D014578:Uroporphyrins; D006886:Hydroxychloroquine