Six patients with erythropoietic protoporphyria; the most common of the porphyrias, were seen at Nagasaki University Hospital and studied clinically and histopathologically. Cutaneous changes were observed in all six patients and are considered to be the result of both protoporphyrin and sunlight. These changes were classified as either acute or chronic, and the chronic changes were examined histologically and revealed a perivascular accumulation of PAS positive material in the upper dermis.Slight aberrations of liver function were found in three of our six cases, and we suggest that the liver cells were involved by a combination of protoporphyrin and sunlight.