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Abstract

Sarcoidosis is a multisystem granulomatous disease of unknown etiology. Immune alterations involving heightened T-helper-1 responses have been proposed to play a major role in the pathogenesis of sarcoidosis. Interferon-alpha therapy and hepatitis C infection have been implicated in the development of a variety of autoimmune diseases. However, despite the wide use of IFN-alpha therapy for hepatitis C, only a few cases of sarcoidosis have been reported in this context. We report the case of a 42-year-old white female with hepatitis C, who developed systemic sarcoidosis shortly after therapy with IFN-alpha2b. The disease was heralded by the appearance of a cutaneous sarcoid/ foreign body granulomatous reaction at the site of an old tattoo. The sarcoidosis responded to a short course of oral prednisone therapy. We also reviewed the other reported cases and discussed the possible immunological mechanisms involved.

Cutaneous Sarcoidosis: An Uncommon Side Effect of Pegylated Interferon and Ribavirin Use for Chronic Hepatitis C

“…Sarcoidosis during IFN therapy may present as systemic, cutaneous or combined disease. The disease has already been reported in tattoos after use of IFN [20]. …”

Subcutaneous Sarcoidosis during Pegylated Interferon Alfa and Ribavirin Treatment for Chronic Hepatitis C

“…It may induce in addition some autoimmune diseases (tiroiditis, lupus erythematosus,…) [4, 6–8]. Sarcoidosis is another recognized adverse effect of IFN-alfa.…”

“…Skin manifestations appear in more than 50% of cases, and patches are the most common form of presentation, but other dermatological signs (subcutaneous nodules, scar infiltration,…) have been reported. Nondermatological symptoms were also observed, being pulmonar involvement the most frequent [4–8]. However, these symptoms are nonspecific and can resemble the usual side effects of IFN- α ; then it is possible that interferon-induced sarcoidosis is underestimated.…”