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Skin-nontumor / Clinical Dermatology

Infectious disorders

Hepatitis C


Reviewer: Mowafak Hamodat MB.CH.B, MSc., FRCPC, Memorial University of Newfoundland (Canada) (see Reviewers page)
Revised: 21 November 2010, last major update September 2010
Copyright: (c) 2002-2010, PathologyOutlines.com, Inc.

Definition
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● Previously major cause of transfusion-associated hepatitis that occasionally causes various cutaneous eruptions

Terminology
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● Constitutes most cases previously called nonA, nonB hepatitis

Epidemiology
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● Transmitted intravenously; associated with IV drug abuse, organ transplant, hemodialysis and health care workers

Clinical features
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● Cutaneous features include cutaneous eruptions, including dermatomyositis-like photodistributed eruptions, folliculitis, palpable purpura, polyarteritis nodosa (Arthritis Care Res (Hoboken) 2010 Oct 27 [Epub ahead of print]), porphyria cutanea tarda (Medicine (Baltimore) 2010;89:69), violaceous acral lesions, ulcers, nodules and urticaria
● Hepatitis C, B, and HIV are among the viral infections associated in the viral infection etiology of lichen planus
● Note: Hepatitis C therapy itself may cause skin rashes, severe inflammatory skin reactions (Gastroenterol Hepatol (NY) 2010;6:326), cryoglobulinemia (Kidney Int 2009;76:818), sarcoidosis (Acta Cytol 2010;54:863) and other cutaneous drug eruptions (Can J Gastroenterol 2009;23:677)

Treatment
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● Combined pegylated interferon (either alfa-2a or -2b) and ribavirin

Clinical images
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Palpable purpura

Treatment related skin disorders

       

Skin rash                   Psoriasis                   Eczema

Micro description
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● Common features are neutrophilic, lymphocytic and granulomatous vasculitis and pauci-inflammatory subtypes
● Also sterile neutrophilic folliculitis, palisading granulomatous inflammation, neutrophilic dermatoses, pyoderma gangrenosum, interface dermatitis and lobular panniculitis, leukocytoclastic vasculitits (J Am Acad Dermatol 2010;63:259)

Micro images
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PAS+ thrombi

Positive stains
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● Perivascular deposits of C3 and IgA by immunofluorescence

Additinal references
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eMedicine

End of Skin-nontumor / Clinical Dermatology > Infectious disorders > Hepatitis C


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