Chronic Hepatitis C A Dermatologic Outlook
Said Amin, Irfanullah, Ishaq Khattak, Muhammad Noor Wazir.
OBJECTIVE: To determine the cutaneous manifestations of hepatitis C virus infection at tertiary care hospital.
METHODOLOGY: This descriptive study was performed in Department of medicine, Khyber
Teaching Hospital Peshawar. Study was performed in the outpatient and inpatient medical units
of Khyber Teaching Hospital Peshawar from 1stJanuary 2009 to 30 June 2010. 325 patients met
the inclusion criteria. Hepatitis C patients of age >15 years and either gender were examined. All
hepatitis C patients, diagnosed by third generation ELISA and/or polymerase chain reaction
were allowed to participate. Subjected to detailed history, careful clinical examination of skin by
dematologist to recognize and diagnose the cutaneous condition. Data was entered in a prestructured Performa. For data interpretation SPSS 14 was used. Descriptive statistics were
used. Mean + standard deviation was sorted for age. Frequencies and percentages for various
variables were calculated.
RESULTS: Of all 325 HCV +ve patients were included in this descriptive study. Male patients
were 61% and female 39%. Mean age was 43 (SD+10 years), ranging from 15 to 78 years. About
one-fourth of patients (23%) were using anti-viral therapy the rest 77% were with out antiviral
therapy. About 41% had one or more cutaneous lesion.
Pruritis was the leading manifestation found in 11%. Lichen planus (oral and cutaneous) was
next found in 6.7% patients. Hyperpigmentation was seen in 5.5% patients. Urticaria (acute &
chronic) was next counting 5.23%. Jaundice, alopecia and vitiligo were seen in 4.9% each. Dry
skin and interferon injection site erythema was observed in 4.6% patients each. Cutaneous vasculitis was noticed in 3.6% each. While Reynauds Phenomenon photosensitivity and psoriasis
were seen in 1.5%1.8% 2.5% patients respectively.
CONCLUSION: Skin lesions are common in patients with anti-HCV patients. Dermatologic lesion may be the initial clue of HCV positivity. Screening studies are needed to find the exact
prevalence of skin manifestations of chronic HCV and its treatment.
Key words: HCV infection, skin manifestations.