Which condition presents with elevated AST/ALT, blistering lesions on the dorsum of the hands, and severe hirsutism?

The condition characterized by elevated AST and ALT levels, blistering lesions on the dorsum of the hands, and severe hirsutism is indeed porphyria cutanea tarda. This disorder is related to deficiencies in the enzymes responsible for heme production, resulting in the accumulation of porphyrins, which can cause photosensitivity and lead to blistering upon sun exposure.

The blistering lesions are typically found on sun-exposed areas, particularly the hands. The significant increase in hair growth or hirsutism can be attributed to the hormonal changes seen in porphyria cutanea tarda, which may arise from liver damage affecting hormone metabolism.

Furthermore, the elevated liver enzymes (AST and ALT) can indicate liver function impairment, commonly associated with this condition, particularly when there is an underlying liver disease or excess iron deposition, which impacts liver function.

Other conditions presented in the choices, while they may share some features, do not align with the combination of symptoms as distinctively as porphyria cutanea tarda does, making it the clear answer to the question.