We report the case of a 51-year-old female patient with no relevant medical history who was a user of hormone replacement therapy (HRT) (estradiol 1 mg + didrogesterone 5 mg) and who had previously received combined oral contraceptives 0.02 mg dquitin
She suffered from lesions on the back of her hands with difficult healing for 5 months.
The directed anamnesis did not refer previous episodes.
Physical examination revealed small erosions, crusts and small blisters affecting the dorsum of the hands.
He also had periorbital hypertrichosis.
It is noteworthy that during 1 month of suspension of HRT, by performing hormonal tests, the lesions disappeared until the resumption of HRT.
Highlights in laboratory tests included: determination of porphyrin in urine 24 h (Merck AUC compatible method < 0.1dL); Uroporphyrin elevation 1086 msec semantics / L (MV IgG reference value) < 21 mc -
Biopsy of a non-bullous lesion was also performed, as they did not exist at the time of biopsy.
It was reported as: skin with skin ulcer, marked dermal edema and lymphocytic and polymorphonuclear neutrophil inflammatory infiltrate, being nonspecific.
Once the diagnosis of PCT was made, HRT was immediately suspended and treatment with phlebotomy of 450 ml every 10 days was initiated, with poor tolerance to the second session. After this, 33% phlebotomy was performed.
After 3 phlebotomy sessions, the patient was evaluated by radiology, suspending treatment, due to the disappearance of clinical manifestations and normalization of liver tests and ferritin.
The suspension of HRT has not reappeared lesions, only persists with facial hypertrichosis under laser therapy.
