Frequency of cutaneous manifestations in patients of hepatitis C infection

Shagufta Anwar, Muhammad Khalid, Jamil Ahmad Shaheen

Abstract


Objective To determine the frequency of cutaneous manifestations in patients suffering from hepatitis C infection.

Methods In this cross-sectional study, one hundred diagnosed patients of hepatitis C, admitted in medical units of Bahawal-Victoria Hospital, Bahawalpur, Quaid-e-Azam Medical College, Bahawalpur were registered over a period of six months. Cutaneous manifestations in these patients were recorded and analyzed.

Results Out of 100 patients, 51 (51%) were males and 49 (49%) were females. Majority of the patients (73%) were 20 to 59 years old. Most of the patients had more than one cutaneous manifestation. These included generalized pruritus 30%, lichen planus 30%, urticaria 26%, leukocytoclastic vasculitis 25%, necrolytic acral erythema 20% and porphyria cutanea tarda 4%.

Conclusion Cutaneous manifestations of hepatitis are not uncommon. These may be the first clinical sign of chronic hepatitis C infection. Generalized pruritus, lichen planus, urticaria, leukocytoclastic vasculitis, necrolytic acral erythema and porphyria cutanea tarda were the important cutaneous manifestations recorded. Screening such patients on the basis of these dermatoses and investigating accordingly may help in early diagnosis and prevention of complications of this grave disease.


Keywords


Hepatitis C, HCV, cutaneous manifestations

Full Text:

PDF

References


Lauer GM, Walker BD. Hepatitis C virus infection. N Engl J Med. 2001;345:41-52.

Neumann AU, Lam NP, Dahari H et al. Hepatitis C viral dynamics in vivo and the antiviral efficacy of interferon-alpha therapy. Science. 1998;282:103-7.

Bukh J, Miller RH, Purcell RH. Genetic heterogeneity of hepatitis C virus: Quasispecies and genotypes. Semin Liver Dis. 1995;15:41-63.

National Institutes of Health Consensus Development Conference Statement: Management of hepatitis C 2002 (June 10- 12, 2002). Gastrenterology. 2002;123:2082-99.

Wasley A, Alter MJ. Epidemiology of hepatitis C: geographic differences and temporal trends. Semin Liver Dis. 2000;20:1-16.

Centers for Disease Control and Prevention. Recommendations for prevention and control of hepatitis C virus (HCV) infection and HCV-related chronic disease. MMWR Recomm Rep. 1998;47:1- 39.

Charlton M. Hepatitis C infection in liver transplantation. Am J Transplant. 2001;1:197-203.

Shah NH, Shabbier G. A review of published literature on hepatitis C and B virus prevalence in Pakistan. J Coll Physicians Surg Pak. 2002;12:368-71.

Cribier B, Santinelli F, Schmitt C et al. Should patients with pruritus be tested for hepatitis C virus infection? A casecontrolled study. Br J Dermatol. 2000;142:1234-64.

Dega H, Frances C, Dupin N et al. Pruritus and the hepatitis C virus. Ann Dermatol Venereol. 1998;125:9-12.

Khokhar N, Gill ML, Malik GJ. General seroprevalence of hepatitis C and hepatitis B virus infections in population. J Coll Physicians Surg Pak. 2004;14:534-6.

Dervis E, Serez K. The prevalence of dermatologic manifestations related to chronic hepatitis C virus infection in a study from a single center in Turkey. Acta Dermatovenerol Alp Panonica Adriat. 2005;14:93-8.

Beaird LM, Kabloon N, Franco J, Fairley JA. Screening of HCV in lichen planus patients. J Am Acad Dermatol. 2001;44:311-2.

Chuang TY, Stitle L, Brashear R, Lewis C. Hepatitis C virus and lichen planus: A case control study of 340 patients. J Am Acad Dermatol. 1999;41:787-9.

Tameez-ud-Deen, Naqqash S, Butt AQ. Lichen planus and hepatitis C virus infection: An epidemiologic study. J Pak Assoc Dermatol. 2003;13:127-9.

Mahboob A, Haroon TS, Iqbal Z et al. Frequency of anti-HCV antibodies in patients with lichen planus. J Coll Physicians Surg Pak. 2003;13:248-52.

Paoletti V, Mammarella A, Basili S et al. Prevalence and clinical features of skin disease in chronic hepatitis C infections. A prospective study in 96 patients. Panminerva Med. 2002;44:349-52.

Ahmed I, Wahid Z, Ahmed Z. Chronic urticaria: frequency of anti-HCV antibodies. J Pak Assoc Dermatol. 2003;13:179-83.

Umar M, Bushra HT, Shuaib A et al. Spectrum of chronic liver disease due to hepatitis C virus infection. J Coll Physicians Surg Pak. 2000;10:380-3.

Karlisberg PL, Le WM, Casey DL et al. Cutaneous vasculitis and rheumatoid factor positivity as presenting signs of hepatitis C virus induced mixed cryoglobulinemia. Arch Dermatol. 1995;131:1119-23.

Ito A, Kazama T, Ito K et al. Purpura with cold urticaria in a patient with hepatitis C virus infection-associated mixed cryoglobulinemia type III: Successful treatment with interferon beta. J Dermatol. 2003;30:321-5.

Chuang TY, Stitle L, Brashear R, Lewis C. Porphyria cutanea tarda and hepatitis C virus: A case control study and metaanalysis of the literature. J Am Acad Dermatol. 1999;41:31-6.

Gisbert JP, Garcia-Buey L, Pajares JM, Moreno-Otero R. Prevalence of hepatitis C virus infection in porphyria cutanea tarda: systematic review and metaanalysis. J Hepatol. 2003; 39: 620-627

Poynard T, Yuen MF, Ratziu V, Lai CL. Viral hepatitis C. Lancet. 2003;362:2095- 2100.

Dupin N, Chosidow O, Lunel F et al. Essential mixed cryoglobulinemiacomparative study of dermatological manifestations in patients infected or noninfected with hepatitis C virus. Arch Dermatol. 1995;131:1424-7.


Refbacks

  • There are currently no refbacks.


ISSN: 1560-9014