A 58-year old woman presents with a chief complaint of skin fragility. There is diffuse blistering and scarring on her hands and distal forearms bilateraly, more so on the left. She is currently taking HRT and Vitamin E supplements, and reports one drink every evening. The patient admits to having her hair tinted because of some uneveness of color. Her urine sample fluoresces pink under a Wood's lamp. A preliminary diagnosis of porphyria cutanea tarda is reached, and order further studies are ordered. Which enzyme of heme synthesis is deficient in porphyria cutanea tarda?
- δ-aminolevulinic acid synthase
- Porphobilinogen deaminase
- Uroporphyrinogen III cosynthase
- Uroporphyrinogen decarboxylase