Abstract: Previous cases of antiretroviral therapy (ART)-induced porphyria cutanea tarda have been reported. We herein report an HIV-infected patient who had received ART for more than 9 years. For nearly one year, he presented with recurrent blisters, crusts and pruritus on sun-exposed sites including the face, neck and dorsa of both hands, which were aggravated by sun exposure. Pigmentation, milia and scars remained after the lesions resolved. Laboratory evaluation revealed elevated serum ferritin; urine exhibited pink fluorescence under Wood's lamp examination. Histopathological examination of the skin tissue revealed subepidermal clefts and the formation of keratinous cysts in the superficial dermis. Periodic acid-Schiff (PAS) staining demonstrated the deposition of purplish-red material around the blood vessels in the superficial dermis.Management included strict photoprotection, hydroxychloroquine, hepatic support, and ART regimen optimization. After one month, the skin lesions were significantly relieved.

Key words: porphyria cutanea tarda, HIV, diabetes