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Abstract
Among 500 patients on maintenance hemodialysis, 6 patients (5 young women and a 49-year-old
man) developed bullous dermatosis, 2–54 months after initiating dialysis treatment.
The skin lesions occurred mainly in sunlight-exposed areas, and 4 out of the 6 patients
showed increased cutaneous fragility in response to trauma. Skin biopsy revealed subepidermal
blisters for all of them, and skin immunofluorescence studies were negative for 2
patients. No increase in fecal or red cell coproporhyrin and protoporphyrin levels
was found in any of the 6 patients. The syndrome was clinically and histologically
indistinguishable from porphyria cutanea tarda.