Peginterferon alfa related psoriasis in a patient with acute hepatitis C and review of the literature

Abstract

The Interferon (IFN) which is the standard treatment for Hepatitis C, may cause a lot of side effects including dermatological anomalies. This paper presents a psoriasis case which occurred in relation with the treatment of acute hepatitis C (AHC) with peginterferon alfa (peg-IFN-α). A 60-year-old male patient came to the hospital with symptoms of high liver enzymes. The patient with history of a recent operation showed anti-HCV(+), HCVRNA 3.5 million IU/mL and HCV genotype 1b in the tests. Without any other etiological factors found in the patient, we started a treatment of peg-IFNα-2b with the diagnosis of AHC. After 3 weeks, psoriatic plaques were observed in various parts of the body. Antiviral treatment of the patient was concluded within 6 months. His psoriasis treatment initially commenced with local agents followed by phototherapy. Permanent viral response was seen in the patient and his lesions recovered rapidly after the antipsoriatic and antiviral treatment. Psoriasis and other autoimmune diseases should be considered even though they are encountered rarely,and the patients should be informed of the possible risks before planning treatment with peg-IFN-α.

Drug-induced psoriasis: clinical perspectives

“…Interferon-alpha treatment is used for multiple indications, including hepatitis B or C infection, Kaposi sarcoma, and various malignancies, such as renal cell carcinoma and metastatic melanoma. Psoriasis has been described predominantly in patients with hepatitis C 21 , 46 , 47 but also infrequently in patients with melanoma, 48 leukemia, 49 , 50 Kaposi sarcoma, and renal cell carcinoma. 51 Of note, both cutaneous and – more rarely – psoriatic arthritis have been linked to interferon-alpha treatment.…”

Guttate psoriasis induced by interferon alfa‐2b suppository treatment for high‐grade cervical intraepithelial neoplasia

“…[1][2][3] Herein, we reported a 46-year-old woman with high-grade cervical intraepithelial The potential mechanism for guttate-like psoriasis lesions associated with INF-α2b could be Th1/Th17 lymphocyte stimulation and increasing cGMP in the cyclic adenosine monophosphate/cyclic guanosine monophosphate (cGMO) balance which plays an essential role in the pathogeneisis of psoriasis. 4 However, the exact underlying relationship between INF-α2b therapy and psoriasis-like lesions is not explicitly stated. Some scholars hold the view that psoriasis skin can be infiltrated by elevated expression of INF-α2b which produced in plasmocytoid predendrtic cells.…”