In porphyria cutanea tarda, which intervention is a recognized treatment modality?

• A. Phlebotomy
• B. Avoid sunlight only
• C. Iron supplementation
• D. Avoid alcohol only

Answer: (A)

Phlebotomy is the recognized treatment because porphyria cutanea tarda involves excess hepatic iron that inhibits the enzyme responsible for processing porphyrins. Removing blood lowers iron stores, which relieves this inhibition, decreases porphyrin buildup, and reduces the skin symptoms caused by sunlight exposure. In practice, regular phlebotomy improves the underlying metabolic defect and clinical manifestations.

Avoiding sunlight helps limit symptoms but does not address the iron-related enzyme inhibition. Iron supplementation would worsen the condition by increasing iron overload. Avoiding alcohol alone reduces a trigger but is not a definitive disease-modifying treatment.