The concept and its significance vary widely among different cultures, but it is especially prominent in the Balkans, Mediterranean and West Asia. The idea appears multiple times in Jewish rabbinic literature. Other popular amulets and talismans used to ward off the evil eye include the hamsa, while Italy (especially Southern Italy) employs a variety of other unique charms and gestures to defend against the evil eye, including the cornicello, the cimaruta, and the sign of the horns. While the Egyptian Eye of Horus is a similar symbol of protection and good health, the Greek evil eye talisman specifically protects against malevolent gazes. Similarly, the Eye-Idols (c. 8700–3500 BC) excavated at the Tell Brak Eye Temple are believed to have been figurines offered to the gods, and according to the Metropolitan Museum of Art, are unrelated to a belief in the evil eye. History
Belief in the evil eye dates all the way back to at least Ancient Ugarit, as it is attested to in texts from this city (ruins in modern-day Syria). Given that the city was destroyed circa 1250BC, during the late Bronze Age collapse to never be rebuilt, the belief dates back at least to this point, and likely earlier. Later in Greek Classical antiquity, it is referenced by Hesiod, Callimachus, Plato, Diodorus Siculus, Theocritus, Plutarch, Heliodorus, Pliny the Elder, and Aulus Gellius. Peter Walcots Envy and the Greeks (1978) listed more than one hundred works by these and other authors mentioning the evil eye.
EPP can also manifest between the ages of 3 and 6.Prolonged exposure to the sun can lead to edema of the hands, face, and feet, rarely with blistering and petechiae. Skin thickening can sometimes occur over time.People with EPP are also at increased risk to develop gallstones. One study has noted that EPP patients suffer from vitamin D deficiency. Liver failure
Protoporphyrin accumulates to toxic levels in the liver in 5–20% of EPP patients, leading to liver failure. The spectrum of hepatobiliary disease associated with EPP is wide. It includes cholelithiasis, mild parenchymal liver disease, progressive hepatocellular disease and end-stage liver disease.A lack of diagnostic markers for liver failure makes it difficult to predict which patients may experience liver failure, and the mechanism of liver failure is poorly understood. A retrospective European study identified 31 EPP patients receiving a liver transplant between 1983 and 2008, with phototoxic reactions in 25% of patients who were unprotected by surgical light filters. The same study noted a 69% recurrence of the disease in the grafted organ. Five UK liver transplants for EPP have been identified between 1987 and 2009. Frequent liver testing is recommended in EPP patients where no effective therapy has been identified to manage liver failure to date. Pregnancy
EPP photosensitivity symptoms are reported to lessen in some female patients during pregnancy and menstruation, although this phenomenon is not consistent, and the mechanism is not understood. Genetics
Most cases of EPP are results of inborn errors of metabolism but the metabolic defect in some patients may be acquired.