Three patients with neglected porphyria cutanea tarda (PCT). There is marked facial involvement: thickened skin with paler areas corresponding to previous blisters and erosions, with marked hyperpigmentation and hypertrichosis. The skin disease of variegate porphyria (VP) tends not to become as severe as this, nor are most patients with PCT who present for treatment early this severely affected. Indeed, if you have PCT, you can be assured that once you start treatment your skin will not become any worse, but will in fact improve.

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