A case report on variegate porphyria after etonogestrel placement

Variegate porphyria (VP) is a rare disorder of heme synthesis caused by an autosomal dominant trait, partial deficiency in the protoporphyrinogen oxidase (PPOX) gene.1 It is characterized by acute attacks of neurovisceral symptoms—behavioral changes and abdominal pain—as well as cutaneous photosensitivity manifesting as skin fragility and blistering.2 Women are more likely to be symptomatic; skin symptoms typically develop in the second decade of life.1 Pertinently, many patients remain asymptomatic throughout their lives, while some patients present with either neurovisceral symptoms, photosensitivity, or both.