Bullous pemphigoid masquerading as porphyria cutanea tarda in a patient on haemodialysis

SIR, Large, tense bullae usually develop over wide areas in bulldu.s pemphigoid IBPI, particularly on covered parts of the body such as the groins, axillae, and flexor surfaces of the forearms.' There have been, however, sporadic reports indicating that ultraviolet exposure initiates or aggravates UP. For example. Ogoshi t'( til.' reported a patient with BP who developed primary lesions on the sun-exposed areas. There are also reports of precipitation or exacerbation of BP lesions by ultraviolet irradiation.' PIVA,' ' and IVB,'' We report a patient who. whilst undergoing haeniodialysis, developed bullous lesions on light-exposed areas, together wilh dry and rough pigmented skin. The distribution of the small, tense blisters resembk-d that found in patients with porphyria cutanea larda (PCTi or other bullous diseases occasionally associated with haemodialysis treatment."