Jan 1, 2005 Table of Contents  Photo Quiz  Glowing Teeth  Am Fam
Physician. 2005 Jan 1;71(1):123-124.  A 45-year-old white man
presented for evaluation because of blistering and scarring of
the dorsal hands for the past several months. The patient also
noticed darker urine but otherwise felt healthy. A Wood’s lamp
examination of the patient’s teeth showed a characteristic glow
(see accompanying figure).    A. Pemphigus vulgaris.  B.
Tetracycline discoloration of teeth.  C. Epidermolysis bullosa.
D. Bullous pemphigoid.  E. Porphyria cutanea tarda.   The answer
is E: porphyria cutanea tarda. In this photograph, the patient’s
teeth are illuminated with a Wood’s lamp (ultraviolet light).
The resultant pink fluorescence is caused by buildup of excess
porphyrins in the teeth. Excess porphyrins also are apparent in
urine, where they are excreted as a water-soluble product.
Wood’s lamp illumination of urine from an affected patient may
reveal a similar fluorescent effect.1  Porphyria cutanea tarda
belongs to a group