Overwhelming diffuse psoriasis during chronic HCV infection, after peginterferon-ribavirin treatment, supported by frequent resort to filgrastim rescue

Induction and exacerbation of psoriasis with Interferon‐alpha therapy for hepatitis C: A review and analysis of 36 cases

“…Our search of the literature worldwide identified a total of 32 peer‐reviewed publications reporting IFN‐α associated psoriasis exacerbation (22 cases) or induction (14 cases) among HCV‐infected individuals 9–40 . Our findings suggest that this side‐effect is not uncommon.…”

“…In cases in which family history of psoriasis was discussed, 100% (8/8 cases) did not have a family history of psoriasis 9,20–22,32–34,40 . In 18 of 19 cases in which HCV status at the time of psoriasis induction/flare was reported, induction/flare of psoriasis occurred during treatment with IFN as the HCV infection was resolving (indicated by negative serum HCV RNA in 11 cases, 11,12,16,17,19,21,22,27,30,32,36 decreasing serum HCV RNA in 1 case 15 and improving serum aminotransferase levels in 6 cases 14,16,18,20,34,38 ).…”

“…Topical therapies, including topical steroids, tars and vitamin D, were a commonly employed treatment (in 10 instances alone, 10,11,13,19,21,29,33,36,37,40 and in 4 in combination with discontinuation of IFN‐α 9,14,17,31 ). This led to a resolution in only 30% of cases when used alone.…”

“…This led to a resolution in only 30% of cases when used alone. Although systemic therapy with cyclosporine, adalimumab or acitretin was begun as treatment in only four cases (used alone three times 20,22,33 and in combination with discontinuation of IFN‐α therapy in one case 38 ), this was more effective than topical therapy, leading to resolution in 100% of cases. Discontinuing IFN‐α therapy occurred in 21 cases, 9,10,12–19,21,29–31,34,36–39 in 14 cases as sole therapy, led to the greatest proportion of resolved cases within weeks of cessation (in 20 of 21 cases, approximately 95%).…”