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Samuel is a 38-year-old male gardener. He visited his family physician because of skin lesions on his hands that began as mild erythematous changes which developed into painful blisters. The blisters
Samuel is a 38-year-old male gardener. He visited his family physician because of skin lesions on his hands that began as mild erythematous changes which developed into painful blisters. The blisters first began erupting during the late spring months. The patient indicated no history of allergic contact dermatitis or other drug or food allergies. The patient consumed about 3-4 12 oz. bottles of beer daily. He showed signs of facial hyperpigmentation with some scarring predominantly in regions of the forehead.
Na+ 136 mmol/L
K+ 4.5 mmol/L
Cl- 102 mmol/L
HCO3- 26 mmol/L
Glucose 163 mg/dL
BUN 13 mg/dL
AST 115 U/L H
ALT 154 U/L H
ALP 176 U/L H
Questions:
1. What clinical symptoms suggest porphyria is present in this patient?
2. What lab data are consistent with a presumptive diagnosis of porphyria?
3. What is the most likely type of porphyria present in this patient? Why?
4. What additional lab data would be helpful in confirming the diagnosis?
