Case 3
A 55-year-old man presented to our dermatology clinic because of blisters on the scalp, face and hand for 6 months. His medical history and family history were both unremarkable. The patient had consumed 200-300 ml of wine every day for 15 years . Physical examination revealed grey-yellowish skin, several bean-sized blood blisters, superficial ulcers and atrophic scars on the scalp ,face, and dorsal of his hands (Figure 3). Conjunctival icterus was noted. Liver function test showed elevated liver enzyme levels: ALT 378 U/L, AST 542 U/L, GGT 254 U/L. Urine porphyrin was positively tested by Wood’s lamp. Therefore, he was diagnosed with PCT and commenced on oral glycyrrhizin and HCQ (200 mg per week). He was also advised to stop alcohol consumption. He did not completely abstain from alcohol, but the daily drinking volume was greatly reduced to one-third of the original amount. His lesion was gradually resolved without relapse during a one-year follow-up.