Erythema Annulare Centrifugum due to Pegylated Interferon-α-2a plus Ribavirin Combination Therapy in a Patient with Chronic Hepatitis C Virus Infection

Abstract

Background: Pegylated interferon-a combined with ribavirin is the current standard treatment for chronic hepatitis C virus infection. During interferon and ribavirin therapy, both local and generalized mucocutaneous adverse reactions have been reported. Erythema annulare centrifugum induced by this therapy regimen has not been reported previously.Case Report: A 29-year-old woman was referred to our clinic for a 1-week history of slightly pruritic annular erythematous eruptions on the lower extremities and hands. The eruptions had first occured on the hands 3 to 4 days after pegylated interferon-a-2a plus ribavirin combination therapy for hepatitis C virus infection. Histopathologic examination supported the diagnosis of erythema annulare centrifugum. The lesions completely regressed within 2 weeks after the cessation of treatment but recurred on similar localizations within 24 hours with the same therapy. It was thought that erythema annulare centrifugum was induced by pegylated interferon-a-2a plus ribavirin combination therapy.Conclusion: Erythema annulare centrifugum is considered an inflammatory skin disease with unknown etiology. It is thought to represent a hypersensitivity reaction to some triggering factors, including infections, immunologie disorders, malign neoplasms, foods, pregnancy, and drugs. We report the first case of erythema annulare centrifigum induced by pegylated interferon-a-2a plus ribavirin combination therapy.

Pediatric Erythema Annulare Centrifugum Treated with Oral Fluconazole: A Retrospective Series

“…Erythema annulare centrifugum (EAC) is an uncommon eruption characterized by persistent erythematous annular plaques with central clearing. The precise etiology of EAC is unknown, but some cases appear to be a hypersensitivity reaction to medications , foods , autoimmune disorders , psychological stressors , or malignancy . EAC has also been reported in association with generalized pediculosis ; molluscum contagiosum ; and herpes zoster , Malassezia , dermatophyte , or Candida infections.…”

Erythema Annulare Centrifugum in the Era of Triple Therapy with Boceprevir plus Pegylated Interferon α-2b and Ribavirin for Hepatitis C Virus Infection

“…3 associated pegylated interferon α 2-a (PEG-IFNα-2a)/RBV in 2013, and recently, Gönül et al reported a new case of EAC during PEG-IFNα-2a/RBV combination therapy in a patient with CHC. 4,5 These 2 previous cases received PEG-IFNα-2a, whereas our patient received PEG-IFNα-2b; therefore, it appears that EAC has now been associated with either the α-2a or α-2b types of pegylated interferons. Although we cannot safely exclude that, in our case, the onset of EAC is due to BOC, it is unclear if BOC may have played a role in the development of this dermatosis.…”

Cutaneous Granulomas Associated With Interferon Therapy

“…4 Remote cutaneous reactions that were reported with IFN therapy include vitiligo, pityriasis rosea, trichomegaly, vasculitis, allergic eczema, and erythema annulare centrifigum. 5 Variable forms of granulomatous reactions were reported in association with IFN therapy. The reaction may be localized to the injection site, 6 disseminated on the skin, 7 or systemic with involvement of internal organs.…”