FECH and autosomal erythropoietic protoporphyria: In Israel, the frequency of IVS3-48C FECH allele was investigated in the Ashkenazi population and was estimated to be similar to that found in European populations, 8%.51 Autosomal recessive inheritance, associated with mutations in both alleles of FECH, has been reported in about 4% of the cases.52 Patients with this recessive form of EPP usually exhibit palmar keratoderma.53