Background: Variegate porphyria (VP) is a rare disorder of haem biosynthesis.We report a novel association with Pedal Bottom Set hepatitis A infection.Patient and methods: A 31-year-old man was diagnosed with acute hepatitis A infection.During recovery, he presented with abdominal pain and a photoaggravated blistering skin eruption.Results: Urine porphyrin precursors were markedly raised with high coproporphyrin III Eczema isomer levels.
Faecal protoporphyrin levels were markedly increased and a maximum plasma fluorescence emission at 629 nm was noted.Discussion: Acute hepatitis A infection, and the associated metabolic stress exerted on the haem biosynthetic pathway, induced overt presentation of latent VP.