The Journal of Dermatology Vol. 17: 329-331, 1990 Short report Desferrioxamine in the Treatment of Porphyria Cutanea Tarda: Ineffectiveness of Intramuscular Administration Juan J. Munoz, Juan Garcia-Cabezas, Juan Martinez-Verano, Carlos Perez-Oteyza and Rafael Enriquez de Salamanca Abstract Four patients suffering from porphyria cutanea tarda received intramuscularly 10-15 g per month of desferrioxamine for periods ranging between 21 and 50 months. Porphyrin excretion was serially analyzed during this treatment. Desferrioxamine administration did not induce remission of the disease, which was sub- sequently achieved after treatment either with phlebotomies or chloroquine. Therefore, chronic intramuscular administration of desferrioxamine alone is ineffective in porphyria cutanea tarda. I{ey words: porphyrins; porphyria; desferrioxamine; chelation , Introduction Venesection is widely considered as a cheap, well-tolerated and highly efficient treatment for porphyria cutanea tarda (PCT) because of its depletion of probable iron stores, and few and conflicting reports have been published (1-5) about the effectiveness of desferrioxamine (DFO). The aim of this work was to evaluate the long-term effect of intramuscular DFO admin- istration on porphyrin excretion in four PCT patients. Patients and Methods Four male PCT patients (41 to 55 years old) with biochemically confirmed PCT were studied. All except one were alcohol consumers (80 to 110 g ethanol! day). Serum iron levels ranged from 136 to 163 pg/ dL. All patients showed minor abnormalities in liver function tests. Received February 3, 1989; accepted for publication February 5,1990. PorphyriaResearch Unit, Department oflntemal Medi- cine, Hospital Clinico Universitario San Carlos Madrid 28040, Spain. Reprint requests to: Dr.Juan]. Munoz, Camino de los Vinateros 40, lOD, Madrid 28030, Spain. Treatment schedule was variable, but all patients received 10-15 g of DFO intramuscularly per month for periods ranging from 21 to 50 months. Porphyrin excretion was quantitated by solvent extraction techniques (6). Individual carboxylic porphyrins were separated by thin layer chromato- graphy of their methyl esters (7) and two PCT- indices were calculated to summarize the main features of the characteristic pattern of porphyrin excretion: Urinary PCT-index=% heptacarboxylic porphyrin x 100/% heptacarboxylic + % tetracarboxylic porphy- nns. Fecal PCT-index=(% heptacarboxylic porphyrin + %isocoproporphyrin) x 100/% heptacarboxylic + % tetracarboxylic + % isocopro porphyrins. Results and Discussion Both quantitative and qualitative (PCT-in- dices) porphyrin excretion followed an erratic pattern during DFO administration (Figs. 1, 2). Porphyrinuria seemed to decrease after one year of treatment in patients A and B, but this effect was likely due to restriction of alcohol intake, since the avoidance of precipitating factors alone can lead to remission in peT (8). On the other hand, relatively short periods of treatment either with phlebotomies (patients A