Mucocutaneous manifestations in hepatitis C patients

Authors

  • Raafia Ali
  • Muhammad Ashfaq
  • Mohammed Azam Bukhari
  • Atif Shahzad

Keywords:

Hepatitis C, mucocutaneous manifestations, extrahepatic manifestations

Abstract

Objective To determine the frequency and nature of mucocutaneous manifestations in hepatitis C virus (HCV) positive patients. Methods Two hundred and five HCV positive patients presenting at the outpatient and inpatient departments of Services Hospital, Lahore were evaluated for mucocutaneous manifestations. Relevant data regarding history, clinical examination including cutaneous system and investigations were documented and analyzed. Results Mean age of patients was 36.6±11.0 years. There were 84 (41%) males and 121 (59%) females. 73.7% cases were exposed to antiviral therapy. Dermatological manifestations were present in 88.3% patients with HCV infection. Pruritus was the most common finding seen in 39.5% followed by hyperpigmentation of skin 34.1%, lichen planus 18%, lingual/buccal pigmentation 13.2%, melanonychia 12.7% and urticaria 6.8%. Less frequent features were palmar erythema, photosensitivity and cutaneous vasculitis. Conclusion Dermatological manifestations may appear as an earliest sign of hepatitis C infection. Therefore, vigilant detection and careful investigation can prevent the complications and further spread of this dreadful disease.

References

Ford N, Kirby C, Singh K et al. Chronic hepatitis C treatment outcomes in low-and middle-income countries: a systematic review and meta-analysis. Bull World Health Organ. 2012;90:540-50.

Hepatitis C An Epidemic for Anyone [online] 2014 [cited 2014 Feb 16]. Available from: URL: http://www.epidemic.org/thefacts/theepidemic/worldPrevalence/.

Cacoub P, Renou C, Rosenthal E et al. Extrahepatic manifestations associated with hepatitis C virus infection. Medicine (Baltimore). 2000;79:47-56.

Muzaffar F, Hussain I, Haroon TS. Hepatitis C: the dermatologic profile. J Pak Assoc Dermatol. 2008;18:171-81.

Asim SA, Wahid Z. Cutaneous Manifestations in Hepatitis C virus infection. Pak J Med Sci. 2012;28:891-4.

Azfar NA, Zaman T, Rashid T, Jahangir M. Cutaneous manifestations in patients of hepatitis C. J Pak Assoc Dermatol. 2008;18:138-43.

Soylu S, Gul U, Kilic A. Cutaneous manifestations in patients positive for anti-hepatitis C virus antibodies. Acta Derm Venereol. 2007;87:49-53.

Raslan HM, Ezzat WM, Abd El Hamid MF et al. Skin manifestations of chronic hepatitis C virus infection in Cairo, Egypt. East Mediterr Health J. 2009;15:692-700.

Sy T, Jamal MM. Epidemiology of hepatitis C virus (HCV) infection. Int J Med Sci. 2006;3:41-6.

Seong MH, Kil H, Kim YS et al. Clinical and epidemiological features of hepatitis C virus infection in South Korea: a prospective, multicenter cohort study. J Med Virol. 2013;85:1724-33.

Paoletti V, Mammarella A, Basili S et al. Prevalence and clinical features of skin diseases in chronic HCV infection. A prospective study in 96 patients. Panminerva Med. 2002;44:349-52.

Ghent C. Cholestatic pruritus. Itch–mechanisms and management of pruritus Bernhard JD eds. 1994;1:229-42.

Dega H, Frances C, Dupin N et al. Pruritus and the hepatitis C virus. The MULTIVIRC Unit. Ann Dermatol Venerol. 1998;125:9-12.

Willems M, Munte K, Vrolijk JM et al. Hyperpigmentation during interferon-alpha therapy for chronic hepatitis C virus infection. Br J Dermatol. 2003;149:390-4.

Gurguta C, Kauer C, Bergholz U et al. Tongue and skin hyperpigmentation during PEG-interferon-alpha/ribavirin therapy in dark-skinned non-Caucasian patients with chronic hepatitis C. Am J Gastroenterol. 2006;101:197-8.

Aguayo-Leiva I, Perez B, Salguero I, Jaen P. Tongue hyperpigmentation during interferon-alpha and ribavirin therapy. Eur J Dermatol. 2009;19:291-2.

Aamir S, Ullah Z, Iqbal Z et al. Cutaneous manifestations of interferon alfa and ribavirin for hepatitis C. J Pak Assoc Dermatol. 2008;18:14-20.

Maticic M. Lichen planus in hepatitis C virus infection: an early marker that may save lives. Acta Dermatovenerol Alp Panonica Adriat. 2007;16:3-6.

Kumar KPM, Jois HS, Hallikerimath S et al. Oral lichen planus as an extra-hepatic manifestation of viral hepatitis-evaluation in Indian subpopulation. J Clin Diagn Res. 2013;7:2068-9.

Cacoub P, Renou C, Rosenthal E et al. Extrahepatic manifestations associated with hepatitis C virus infection. Medicine (Baltimore). 2000;79:47-56.

Cribier BJ, Santinelli F, Schmitt C et al. Chronic urticaria is not significantly associated with hepatitis C or hepatitis G infection: a case-control study. Arch Dermatol. 1999;135:1335-9.

Malik LM, Mufti S, Saeed S et al. Hepatitis C seropositivity in patients with acute and chronic urticaria. J Pak Assoc Dermatol. 2008;18:144-8.

Salem A, Gamil H, Hamed M et al. Nail changes in patients with liver disease. J Eur Acad Dermatol Venereol. 2010;24:649-54.

Zaiac MN, Daniel CR. Nails in systemic disease. Dermatol Ther. 2002;15:99-106.

Kostic V, Jovanovic M, Radovic J et al. Side effects of antiviral therapy in patients with chronic hepatitis C infection. Med Pregl. 2012; 65: 106-10.

Goh C. Hepatitis C treatment and alopecia totalis. J Investig Dermatol Symp Proc. 2013;16:S59-60.

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Published

2016-11-29

How to Cite

1.
Ali R, Ashfaq M, Bukhari MA, Shahzad A. Mucocutaneous manifestations in hepatitis C patients. J Pak Assoc Dermatol [Internet]. 2016Nov.29 [cited 2025Feb.9];24(1):40-5. Available from: http://www.jpad.com.pk/index.php/jpad/article/view/172

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