Overview of Cutaneous Porphyrias By Herbert L Bonkovsky, MD, Wake Forest University School of Medicine; Sean R Rudnick, MD, Wake Forest University School of Medicine Reviewed / Revised Dec 2022 View Patient Education Topic Resources Some Less Common Porphyrias Cutaneous porphyrias result from deficiency (and in one case, excess) of certain enzymes in the heme biosynthetic pathway (see table), resulting in a relatively steady production of phototoxic porphyrins in the liver or bone marrow.