Porphyria cutanea tarda (PCT) is a vesiculobulIous disorder often associated 
with estrogens, hepatitis C virus (HCV), alcoholism, hereditary hemochromatosis 
(HH), and human immunodeficiency virus. Hepcidin, a peptide hormone produced by 
the liver, has been associated with iron metabolism in 3 common precipitating 
factors for PCT: HCV, HH, and alcohol consumption. We present the case of a 
patient with erosions and noninflammatory bullae on his hands and forearms who 
received a diagnosis of PCT. On further examination, the patient was found to be 
positive for 3 precipitating factors: HCV, an HH gene mutation, and alcohol use. 
For patients with PCT, it is important to perform phenotypic screening for HCV 
and HH. Targeting hepcidin with replacement therapy to decrease iron may be a 
treatment of not only HCV, HH, and alcoholic cirrhosis, but also PCT.