Porphyria cutanea tarda (PCT) is a defect of uroporphyrinogen decarboxylase that can be acquired or inherited through autosomal dominant transmission. This disorder becomes active only after additional liver-specific precipitating factors, such as alcohol, drugs, or viral infections (hepatitis, HIV) are present. Among the precipitating factors of hepatic porphyria, estrogens also play an important role; estrogen-containing contraceptives have been implicated in the manifestation of PCT in young women. It is known that all of these factors either inhibit uroporphyrinogen decarboxylase or lead to liver damage as a result of direct or indirect deposition of iron in the liver. Perimenstrual improvement of PCT has been explained by menstrual bleeding, which, similar to therapeutic bloodletting, leads to a reduction of iron (36).
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