Primary healthcare with referral to Dermatology.Woman, 33 years old, with no previous medical history, goes to her Family Medicine physician with blister-like cutaneous lesions that emerge and resolve spontaneously and intermittently, predominantly involving her hands, arms, anterior chest and lower extremities for the last seven years. In the past year, she has exhibited the same type of lesions in a persistent pattern, primarily affecting arms and hands. Any other symptoms where denied. Initially a diagnosis of scabies was made, starting permethrin as treatment. Due to lack of clinical improvement, the patient consult again at a Primary Care, so she was referred to Dermatology. At Dermatology in the physical exam it was described blistering and crusted skin lesions in the back of the hands and forearms. Urine and blood where analyzed, in urine elevated uroporphyrin was found and in blood elevated liver enzymes where reported, with those findings, porphyria cutanea tarda (PCT) was made and the patient started a follow-up.This was a typical PCT case, but is interesting that initially an scabies diagnosis was made. Since the lesions of the patient had an intermittent pattern and she’d never consult for this before, it was difficult to make a proper diagnosis in the first consult, in her second visit to consult, a new physical exam was made and the patient was referred to Dermatology.In Primary Care, PCT should be suspected in adults presenting with fragile, photosensitive skin on sun exposed areas specially in hands with blisters, erosions, milia, and hypertrichosis.PCT is a common type of porphyria and results from decreased activity of uroporphyrinogen decarboxylase, leading to porphyrin accumulation in the skin and liver. It typically presents with photosensitive, fragile skin on sun-exposed areas, causing vesicles, bullae, erosions, and scarring after minimal trauma. Risk factors include alcohol use, hepatitis C, HIV, estrogen therapy, sun exposure, and iron overload. The Primary Care physician, should control those risk factors in patients with PCT.Early recognition of PCT in Primary Care is essential to prevent ongoing skin damage. Prompt referral, targeted investigations, and trigger avoidance enable effective management and improve long-term outcomes.