Skin diseases associated with hepatitis C virus: Facts and controversies

Cutaneous Reactions in Patients with Chronic Hepatitis C Treated with Peginterferon and Ribavirin

“…The category of possibly HCV-related diseases includes psoriasis, polyarteritis nodosa and Sjögren syndrome. Some miscellaneous diseases are occasionally related to HCV, such as prurigo, leukocytoclastic vasculitis, urticaria, erythema nodosum, erythema multiforme, Behçet disease, and even rarely seen erythema gyratum repens [3,14,15]. In our group of patients, except the above-mentioned case with exacerbation of lichen planus, no HCV-related disease was noted.…”

“…The frequency of the cutaneous reactions among our 271 patients was 13.5%. Other calculations found at least 1 skin manifestation in up to 17% of the patients [2], and local cutaneous reactions at the site of injection in up to 20% as well as diffuse cutaneous reactions and specific cutaneous diseases in about 25% of the patients [3]. Cutaneous adverse reactions like alopecia, dry skin, pruritus, rash and eczema are described firstly during the era of interferon monotherapy.…”

The Skin and Viral Liver Disease

“…mixed cryoglobulinemic vasculitis, porphyria cutanea tarda and lichen planus show the highest robustness on both biological and epidemiological ground. On the other hand, the clinical alliance between HCV and a broad list of other skin conditions has not yet received sufficient support [9,11]. In this context, anecdotal reports have mostly been made in the literature of associations with pityriasis rubra pilaris [12] [26].…”

“…In fact, the appearance of cutaneous lesions on extremities, particularly in cooler weather, must always raise clinical suspicion. The spectrum of skin involvement in MC ranges widely from 'palpable purpura' (which is the absolutely prevalent clinical scenario) [9] to urticarial vasculitis, necrotizing vasculitis, isolated necrotic ulcers, acral ischemias, acrocyanosis, and livedo reticularis (Figure 7 and 8). Of note, even in cases characterized by the highest clinical severity, the skin behaves very often like a sort of 'emuntory system', with poor or absent signs of internal organ involvement.…”

“…Cutaneous manifestations of acute infection are sporadic and show no substantial specificity, ranging from urticaria, erythema multiforme, leukocytoclastic vasculitis to erythema nodo-sum. On the contrary, there exists a wide panel of skin conditions linked, to a varying degree, with chronic HCV infection [8,9]. The occurrence of skin disorders of any type has been in fact reported in up to 17% of HCV patients (Table 1) [10].…”