Necrotizing fasciitis associated with porphyria cutanea tarda

A case is presented of a 31-year-old white woman with necrotizing fasciitis. She had had a previous diagnosis of porphyria cutanea tarda that was manifested in part by bullous lesions on her forearms and hands. A soft tissue infection developed in her left hand and forearm in an area of bullous disease. After a delay of 8 days the diagnosis of necrotizing fasciitis was made. She recovered following surgical debridement, extensive fasciotomy, broadspectrum antibiotic coverage, and hyperbaric oxygen therapy.