A comparative trial of desferrioxamine and hydroxychloroquine for treatment of porphyria cutanea tarda in alcoholic patients.

Forty male alcoholic patients with porphyria cutanea tarda (PCT) were randomly assigned to 2 groups of 20. The 1st group received desferrioxamine (30 mg/kg body weight/day for 1 week every 3 months) whereas the latter was given hydroxychloroquine (200 mg twice/wk orally). Alcohol abstinence was advised for all patients. Improvement of cutaneous signs was evident after 6 months in hydroxychloroquine-treated subjects and after 12 months in desferrioxamine-treated subjects. At the end of the 1-year clinical trial, significant decreases of serum iron and ferritin were found in all patients, irrespective of the therapy. Urinary total porphyrins were reduced significantly in both groups, but the drop was significantly more evident in hydroxychloroquine- than in desferrioxamine-treated subjects. After 1 year of therapy, 4 desferrioxamine-treated patients vs 16 hydroxychloroquine-treated subjects acquired a normal urinary porphyrin pattern. These results indicate that hydroxychloroquine is more effective than desferrioxamine in inducing clinical and biochemical remission of PCT. Accordingly, hydroxychloroquine should be the preferred alternative to phlebotomy, if the latter is contraindicated.