ABSTRACT
Porphyria cutanea tarda (PCT), a relatively uncommon disease, has recently been reported in patients infected with the human immunodeficiency virus (HIV). Although PCT and HIV infection may co-exist by chance, the increasing number of reported cases suggest that HIV or an associated factor triggers the development of PCT in predisposed individuals. We report four additional cases of PCT in HIV seropositive patients and review the previously reported cases. The possible links between PCT and HIV are discussed. We believe the diagnosis of PCT should prompt investigation for HIV infection in all patients.
Subject(s)
HIV Infections/complications , Porphyrias/microbiology , Skin Diseases/microbiology , Adult , Humans , Male , Middle AgedABSTRACT
It is generally accepted that cutaneous Lyme borreliosis comprises erythema chronicum migrans, lymphadenosis benigna cutis, and acrodermatitis chronica atrophicans. In recent years the tick-borne spirochete Borrelia burgdorferi has been associated with a number of other cutaneous disorders. We therefore investigated sera from 175 patients with localized scleroderma (morphea) (n = 64), systemic sclerosis (n = 74), granuloma annulare (n = 16) and porphyria cutanea tarda (n = 21) with the new, highly sensitive and specific Borrelia burgdorferi flagellum ELISA assay. As controls (n = 297) served normal healthy volunteers and patients with other skin diseases. It was found that the distribution of individual antibody values and the median antibody levels were identical in controls and in patients with scleroderma, granuloma annulare and porphyria cutanea tarda. These data do not support the hypothesis of an etiological association between Borrelia burgdorferi infection and scleroderma, granuloma annulare or porphyria cutanea tarda.
Subject(s)
Borrelia/immunology , Flagella/immunology , Skin Diseases/microbiology , Adolescent , Adult , Aged , Enzyme-Linked Immunosorbent Assay , Female , Granuloma/immunology , Granuloma/microbiology , Humans , Male , Middle Aged , Porphyrias/immunology , Porphyrias/microbiology , Scleroderma, Localized/immunology , Scleroderma, Localized/microbiology , Scleroderma, Systemic/immunology , Scleroderma, Systemic/microbiology , Skin Diseases/immunologyABSTRACT
Serum markers of hepatitis B virus (HBV) infection were determined in 82 patients with porphyria cutanea tarda (PCT). Pathogenetic factors (alcohol, thalassemia minor, drugs) and clinical and histologic findings of PCT were taken into account. The prevalence of HBV infection was very high (70.7%). Hepatitis B surface antigen (HBsAg) was positive in 14 patients (17%). Eight patients had HBV infection as the only documented acquired factor. The clinical picture and histologic findings were aggravated by HBV infection; primary hepatic carcinoma occurred in four patients with HBV infection. Liver siderosis was histologically documented in 82.6% of cases, serum ferritin was pathologically increased in 91%, confirming the role of iron overload in PCT. A correlation (p less than 0.02; chi-squared method) was found between increased serum ferritin levels and HBV infection, suggesting a possible relationship between liver siderosis and HBV clearance. HBV infection appears to be a relevant additional factor in the pathogenesis of PCT liver disease.
Subject(s)
Hepatitis B/complications , Liver Diseases/pathology , Porphyrias/etiology , Skin Diseases/microbiology , Adult , Aged , Female , Ferritins/blood , Hepatitis B/pathology , Hepatitis B Antibodies/analysis , Hepatitis B Antibodies/immunology , Hepatitis B Surface Antigens/immunology , Humans , Liver Diseases/complications , Male , Middle Aged , Porphyrias/microbiology , Porphyrias/pathology , Porphyrins/metabolism , Porphyrins/urine , Siderosis/pathology , Skin Diseases/pathologyABSTRACT
In 40 patients suffering from porphyria cutanea tarda the sera were examined for the existence of HBAg and HBAb. Hepatitis was known in the history of 6 patients, in 3 of 23 bioptically examined livers a chronic aggressive hepatitis could be proved. When the transmigration electrophoresis after Pesendorfer and coworkers was used, in no case HBAg and HBAb could be proved.
