Skin manifestations of chronic hepatitis C virus infection in Cairo, Egypt

Raslan, Hala M.; Ezzat, Waffa M; Hamid, M.; Emam, Hossam; Amre, K S

doi:10.26719/2009.15.3.692

Cited by 27 publications

(27 citation statements)

References 22 publications

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“…The cause of pruritus in chronic hepatitis C is not well understood, although it has been associated with liver fibrosis, bile duct lesions and cholestasis [8][9][10][11] . In addition, hepatitis C may cause a primary skin disorder with pruritus as a symptom [5] .…”

Section: Discussionmentioning

confidence: 99%

Study of pruritus in chronic hepatitis C patients

Suzuki¹,

Tamano²,

Katayama³

et al. 2014

WJG

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AIM:To investigate the occurrence and severity of pruritus in chronic hepatitis C patients treated with or without interferon (IFN) therapy. METHODS:A total of 89 patients with chronic hepatitis C and 55 control (non-hepatitis) patients were asked to rate their experience of diurnal and nocturnal pruritus in the preceding week using a visual analogue scale (VAS) and a five-point scale, respectively. Blood samples were taken and serum thymus and activationregulated chemokine (TARC) levels were measured by enzyme-linked immunosorbent assay. RESULTS:A significantly greater proportion of chronic hepatitis C patients experienced nocturnal pruritus compared with control (58.4% vs 5.5%, P < 0.0001).Chronic hepatitis C patients also had more severe pruritus compared with control patients, indicated by the higher mean VAS scores in both the IFN-treated and non-IFN-treated groups. In particular, patients who received combined peginterferon alfa-2b and ribavirin had significantly higher mean VAS scores than those receiving peginterferon alfa-2a or no IFN treatment. Serum TARC levels did not correlate with pruritus scores, and no significant differences in TARC levels were observed between the IFN-treated and non-IFN-treated groups. CONCLUSION:Patients with chronic hepatitis C experience pruritus more than those without. Serum TARC levels do not correlate with pruritus severity in chronic hepatitis C patients. Key words: Hepatitis C; Pruritus; Peginterferon; Ribavirin; Thymus and activation-regulated chemokine Core tip: This is the first paper to evaluate the occurrence and severity of pruritus in chronic hepatitis C patients and to examine the relationship between pruritus and interferon therapy. We found that patients with chronic hepatitis C experience pruritus more than those without chronic hepatitis C.

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Section: Discussionmentioning

confidence: 99%

Study of pruritus in chronic hepatitis C patients

Suzuki¹,

Tamano²,

Katayama³

et al. 2014

WJG

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“…3 These cutaneous diseases, while not exclusive to this patient population, occur more frequently in patients with chronic HCV. 4–5 In addition, necrolytic acral erythema (NAE) has recently been described as a distinctive skin lesion found in patients with chronic HCV infection. 6–7 …”

Section: Introductionmentioning

confidence: 99%

Low prevalence of necrolytic acral erythema in patients with chronic hepatitis C virus infection

Raphael

Dorey-Stein

Lott

et al. 2012

Journal of the American Academy of Dermatology

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Background Chronic hepatitis C virus (HCV) infection is associated with necrolytic acral erythema (NAE). However, the prevalence of NAE among HCV patients is unknown, and the clinical and histological features have not been well defined. Objective To determine the prevalence, overall clinical features, and cutaneous histopathological characteristics of NAE patients. Methods A cross-sectional study was performed among chronic HCV-infected patients cared for at three Philadelphia hospitals. Patients completed a questionnaire and underwent a dermatologic examination. All undiagnosed skin lesions with clinical features of NAE as described in the literature underwent skin biopsy. Results Among 300 patients with chronic HCV infection (median age, 55 years; 73% male; 70% HCV genotype 1), five (prevalence, 1.7%; 95% CI, 0.5 – 3.8%) had skin lesions consistent with NAE clinically, which were analyzed and confirmed with skin biopsy. All five skin biopsies demonstrated variable psoriasiform hyperplasia, mild papillomatosis, parakeratosis, and necrotic keratinocytes in the superficial epidermis. All 5 patients were >40 years old, African American males, infected with HCV genotype 1 and had a high viral load (>200,000 IU/mL). Limitations Previous descriptions of NAE were used to guide the evaluation and need for a biopsy; however, other unknown clinical characteristics of the disease may exist. The senior author was the sole interpreter of the biopsies. Only 300 of the 2500 eligible patients enrolled in the study. Conclusion The prevalence of NAE among chronic HCV patients in this sample was very low. Further research is needed to determine the etiology and appropriate therapies of NAE.

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“…These include -but are not limited to-lichen planus, acral necrolytic erythema, sialadenitis, and Mooren's corneal ulceration. [15,16] Nonetheless, the occurrence of a skin malignancy as a direct dermatological manifestation of HCV is very unusual.…”

Section: Discussionmentioning

confidence: 99%

Unusual association of Merkel-cell carcinoma and hepatocellular carcinoma in alcohol and hepatitis C virus-related cirrhosis: Casual or causal relation?

Addario

Hashim²,

Marino

et al. 2017

CRIM

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Background: Merkel-cell carcinoma (MCC) is a rare and highly aggressive skin cancer. The estimated annual incidence rate of MCC is increasing, and the mortality rate is considerably higher worse than that of cutaneous melanoma. The risk of MCC is higher in immunosuppressed patients and in those with other malignancies. Case representation: The present report is the first description of MCC associated with hepatocellular carcinoma in an immunocompetent patient with alcohol and hepatitis C virus (HCV)-related liver cirrhosis. Conclusions: This case supports the hypothesis of HCV systemic oncogenicity, suggested by previous reports describing an association of this virus with lympho-proliferative disease, gastrointestinal, kidney, and breast malignancies, even though a causal relation or mechanism have not been clearly established. Further studies are needed to clarify whether the impairment of immune system associated with advanced cirrhosis may also play a role, by allowing opportunistic viruses to initiate oncogenic pathways. This paper finally highlights the importance of the screening for skin and systemic disorders in patients with chronic hepatitis C.

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Skin manifestations of chronic hepatitis C virus infection in Cairo, Egypt

Cited by 27 publications

References 22 publications

Study of pruritus in chronic hepatitis C patients

Study of pruritus in chronic hepatitis C patients

Low prevalence of necrolytic acral erythema in patients with chronic hepatitis C virus infection

Unusual association of Merkel-cell carcinoma and hepatocellular carcinoma in alcohol and hepatitis C virus-related cirrhosis: Casual or causal relation?

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