Re-Evaluation of the Diagnosis of Porphyria Cutanea Tarda in Admiral Sir Francis Beaufort

Abstract

ObjectivesTwo biographies of Admiral Francis Beaufort (1774–1857) have stated that, aged 20–25 years, he suffered from porphyria cutanea tarda (PCT) that was ‘cured’ following severe blood loss during a naval skirmish. We have examined the evidence concerning the nature of his skin disease.DesignPrimary records, most notably Beaufort's correspondence with his family, his journals and his father's diaries were sought out and analysed.SettingThis case report is discussed in the context of 18th-century naval medicine and concepts and treatment of skin disease.ResultsThe description of his lesions, their age of onset, their progression and response to treatment, particularly topical tar and associated features are quite inconsistent with a diagnosis of PCT. His mother, Mary Waller Beaufort (1739–1821), consulted Dr Robert Darwin in 1803 about a painful skin disease affecting her legs. Detailed description of the lesions and a contemporary diagnosis are not available but possible diagnoses include chronic psoriasis and stasis eczema.ConclusionsA more tenable diagnosis is that Francis Beaufort had chronic plaque psoriasis remitted by bed rest and convalescence in the sunny Mediterranean climate with cessation of alcohol consumption and improved nutrition as well as topical and oral medications.

The life and times of Francis Geach MD, FRS (1730–1798), Senior Surgeon to the Royal Naval Hospital, Plymouth (1778–1798)

“…By contrast, Dr Thomas Trotter a senior naval physician, assumed a diagnosis of a venereal infection. 3…”

“…He first came to the attention of the current authors during a detailed re-evaluation of the recent claims 1,2 that, as a Midshipman and Junior Lieutenant in the Royal Navy, Admiral Sir Francis Beaufort (1774–1857) suffered from porphyria cutanea tarda. 3 This disabling skin disease dating from at least 1794 was diagnosed in January 1797 as of venereal origin by Dr Thomas Trotter (1760–1832), Physician to the Fleet, who suggested an immediate course of mercurial treatment. Beaufort rejected this diagnosis and in June 1797 consulted Dr Geach of Plymouth and was diagnosed as suffering from Greek leprosy (psoriasis).…”