Most porphyrias are genetic. Scientists identified the genes for each of the enzymes used to make heme and, through testing, can recognize which is abnormal. Some types of porphyrias only occur when the person inherits a mutated gene from each parent, while others require only a single inherited mutation. One type, porphyria cutanea tarda, is not genetic and stems from outside causes, including excess iron, smoking, alcohol use, HIV, hepatitis C, and estrogen use.

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