JAMES P. MANNION, M.D.
To the editor: I note that Hall and associates (1) fail to consider porphyria cutanea tarda as a diagnosis (2). Lupus erythematosus, either discoid or systemic, and porphyria cutanea tarda may co-exist, and either may present with photosensitivity. The description of the skin changes in all four patients seemed compatable with porphyria cutanea tarda. All four patients had been taking antimalaria drugs, which have been known to unmask porphyria cutanea tarda. For this reason, urinary porphyrins should be measured before antimalarial therapy in any case of lupus erythematosus, and I suggest this for the authors' consideration.
MANNION JP. Bullous Eruption in Lupus Erythematosus. Ann Intern Med. ;98:261. doi: 10.7326/0003-4819-98-2-261_1
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Published: Ann Intern Med. 1983;98(2):261.
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