Porphyria cutanea tarda in a middle-aged man with alcohol consumption

Porphyria cutanea tarda (PCT) is a rare condition characterized by impaired heme synthesis affecting the skin. This case report describes the presentation and diagnosis of PCT in a 42-year-old man with a history of alcohol consumption. Following a family vacation at a beachside resort, the patient developed tense blisters with scarring and milia on both hands and forearms. Histopathological analysis showed a pauci-cellular subepidermal bulla. The dermal papilla showed few slender protrusions into the bullous space. The dermal blood vessel showed moderate mononuclear cell infiltration around blood vessels. The basement membrane zone (BMZ) appeared thickened. The dermis showed mild inflammation. Direct immunofluorescence revealed intense homogeneous deposits in the blood vessels of the papillary dermis and granular deposits at the BMZ of immunoglobulin G, immunoglobulin A, and C3. This case underscores the importance of considering PCT as a possible complication in patients with a history of alcohol consumption.