Cutaneous Reactions in Patients with Chronic Hepatitis C Treated with Peginterferon and Ribavirin

Abstract

Background/Objective: Peginterferon alfa and ribavirin could cause various cutaneous reactions. Treatment-related cutaneous reactions are common, and treatable complications can contribute to the treatment discontinuation. Methods: We performed a 6-year prospective study of cutaneous reactions in 271 patients with chronic hepatitis C treated with peginterferon and ribavirin. Results: Cutaneous reactions of mild to moderate degree were seen in 36 (13.3%) patients: localized cutaneous reactions in 7 (2.6%) patients, generalized reactions - pruritus, skin xerosis and eczematous changes - in 28 (10.3%) patients, alopecia in 11 (4.1%) patients; exacerbation of lichen planus was seen in 1 patient. Conclusion: The study showed a relatively low prevalence of cutaneous reactions without the need for discontinuation of any of the drugs used. These reactions correlated only with the age of the patients and treatment duration. This finding is of particular importance with regard to the recently introduced direct-acting antivirals in the treatment of hepatitis C virus infection, which can cause a very severe form of cutaneous reactions.

Chronic Hepatitis C Treatment-Related Skin Rash: A Report of Two Cases

“…In some of the studies, skin lesions were resolved without discontinuation of therapy in the majority of patients (9,10,11). In one of these studies performed by Patrk and colleagues, it is pointed that the number of patients followed without discontinuation of therapy was less than the number of those continued therapy (9). In our second case, skin lesions recovered without discontinuation of anti-HCV treatment and with using symptomatic treatment, including antihistamines and topical steroid.…”

“…This reason gives rise to thought that skin eruptions might be seen more frequent due to ribavirin. In some of the studies, skin lesions were resolved without discontinuation of therapy in the majority of patients (9,10,11). In one of these studies performed by Patrk and colleagues, it is pointed that the number of patients followed without discontinuation of therapy was less than the number of those continued therapy (9).…”

Lesiones eccematosas de distribución generalizada

“…A distancia de éste se ha descrito la aparición de sarcoidosis, urticaria, fenómeno de Raynaud, alopecia y la exacerbación de dermatosis previas como la dermatitis atópica, la psoriasis o el lupus eritematoso 3 . La ribavirina puede producir reacciones de fotosensibilidad [4][5][6] . Con el telaprevir es muy frecuente la aparición de anemia por lo que el control hematológico mediante un hemograma es primordial 2 .…”

Erosive oral lichen planus after pegylated-interferon therapy for chronic hepatitis B

“…LP has been reported to develop or worsen with interferon therapy, largely in the context of hepatitis C. 4 , 5 , 6 A prospective study found that of 67 patients with hepatitis B and 45 patients with hepatitis C treated with recombinant interferon α (IFN-α), 1 patient with hepatitis B and 2 with hepatitis C developed LP. 5 Another study of 271 patients with hepatitis C treated with peginterferon and ribavirin found an exacerbation of lichen planus in 1 patient.…”