Porphyria cutanea tarda (PCT) is considered an extra-hepatic manifestation of HCV
infection. The frequency of this association varies according to different authors and the mechanism by which the virus can trigger this disease is not yet clear. We present a 47-year-old-man with
chronic hepatitis C genotype 1b who, during the treatment with peg-interferón alfa 2b plus ribavirina, with no detectable
viremia at weeks 12th, 24th, and 48th, developed dermatological photosensitive lesions at week 44th. With a presumptive diagnosis of PCT a cutaneous/skin biopsy was performed as well as a
porphyrin dosage with urine porphyirins of 4185 microg/24 hs (nv<250). The chromatographic analysis revealed the typical PCT pattern thus confirming the diagnosis. The
hemochromatosis HFE gen evaluation showed heterozigotus character mutations (H63D and C282Y) a frequent association in patients with
iron overload and PCT. The
antiviral treatment of the HCV
infection can improve the clinical-humoral manifestations of PCT. The novo occurrence of PCT was recently reported during
chronic hepatitis C treatment with interferón and
ribavirin, but no cases of late appearance of PCT in patients with no detectable
viremia were reported. The mutation of the gen HFE in our patient and the
hemolysis caused by
ribavirin can be related to the development of the disease, but the
iron overload because of
ribavirin use is also controversial. This is another example of the complexity of this association.