{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,21]],"date-time":"2026-06-21T14:39:51Z","timestamp":1782052791532,"version":"3.54.5"},"reference-count":47,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,2,17]],"date-time":"2019-02-17T00:00:00Z","timestamp":1550361600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J Dermatology"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Porphyria cutanea tarda (<jats:styled-content style=\"fixed-case\">PCT<\/jats:styled-content>) is the most common porphyria worldwide. The known acquired precipitating factors that induce <jats:styled-content style=\"fixed-case\">PCT<\/jats:styled-content> include alcoholism, hepatitis C virus infection, human immunodeficiency virus infection, and estrogen intake. Hereditary hemochromatosis is considered an inherited risk factor. The aim of this study was to describe and analyze precipitating factors and family history, with emphasis on <jats:styled-content style=\"fixed-case\">PCT<\/jats:styled-content> management.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective study of 87 patients with <jats:styled-content style=\"fixed-case\">PCT<\/jats:styled-content> was conducted between January 2002 and December 2017.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A male predominance of 1.8\u00a0:\u00a01 was found. The median age at diagnosis was 49\u00a0years (range 18\u201371). Family history of <jats:styled-content style=\"fixed-case\">PCT<\/jats:styled-content> was observed in 19.5% of patients. Two or more acquired precipitating factors were present in 42.5%. Patients were treated with antimalarial monotherapy (72.4%), antimalarial combined with phlebotomy (22.9%), and only with phlebotomy (4.6%). Acquired precipitating factors and inherited factors were not associated with treatment group. There was a difference in 24\u00a0h\u2010<jats:styled-content style=\"fixed-case\">UP<\/jats:styled-content> normalization rate between treatment groups; combined therapy takes longer than antimalarial monotherapy, 38\u00a0months versus 15\u00a0months, respectively (CI 95%, 6.5\u201363.5 vs. 12.9\u201317) (log\u2010rank test, <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.004).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Precipitating factors did not seem to be associated with treatment choice; however, all acquired and inherited precipitating factors should be investigated, and the choice between phlebotomy and\/or antimalarials should be individualized. All dermatologists treating <jats:styled-content style=\"fixed-case\">PCT<\/jats:styled-content> patients should observe transferrin saturation and ferritin levels to search for underlying hereditary hemochromatosis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ijd.14398","type":"journal-article","created":{"date-parts":[[2019,2,18]],"date-time":"2019-02-18T05:49:01Z","timestamp":1550468941000},"page":"925-932","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Experience in management of porphyria cutanea tarda in a tertiary referral Brazilian hospital from 2002 to 2017"],"prefix":"10.1111","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1566-3977","authenticated-orcid":false,"given":"Julia Elisa","family":"Cabezas Arteaga","sequence":"first","affiliation":[{"name":"Department of Dermatology Hospital das Cl\u00ednicas University of S\u00e3o Paulo Medical School S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima Mendon\u00e7a Jorge","family":"Vieira","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hospital das Cl\u00ednicas University of S\u00e3o Paulo Medical School S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5705-4104","authenticated-orcid":false,"given":"Vitor Manoel","family":"Silva dos Reis","sequence":"additional","affiliation":[{"name":"Department of Dermatology Hospital das Cl\u00ednicas University of S\u00e3o Paulo Medical School S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,2,17]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(79)90403-0"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.13580"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.12305"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2004.09.014"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1590\/abd1806-4841.20132048"},{"key":"e_1_2_6_7_1","doi-asserted-by":"crossref","first-page":"3454","DOI":"10.1182\/blood.V112.11.3454.3454","article-title":"The uroporphomethene inhibitor causitive for porphyria cutanea tarda (PCT) is generated by oxidation of hydroxymethylbilane (HMB)","volume":"112","author":"Phillips JD","year":"2008","journal-title":"Blood"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-3231.2012.02794.x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2008-02-138222"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1517\/14656566.6.3.377"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2012.09.005"},{"key":"e_1_2_6_12_1","first-page":"1228","volume-title":"Fitzpatrick's Dermatology in General Medicine","author":"Bickers DR","year":"2012"},{"key":"e_1_2_6_13_1","volume-title":"World Health Organization: Global Status Report on Alcohol and Health","author":"World Health Organization","year":"2014"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.4065\/77.6.522"},{"key":"e_1_2_6_15_1","first-page":"1225","article-title":"Chloroquine in the treatment of porphyria cutanea tarda symptomatica. 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