Hepatitis c skin changes

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 13.02.2023

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Synonym(s)

Hepatitis C and skin changes; Skin changes in hepatitis C infection; Skin symptoms due to hepatitis C infections

Definition
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Hepatitis C is an acute or chronic infection (> 6 months) caused by the hepatitis C virus (HCV), a hepatotropic RNA virus of which 6 gene types (1-6) are known. The infection leaves no lasting immunity. Extrahepatic involvement is multiform and polyetiologic. They involve the lymphatic-immunologic system, thyroid, kidney, skeletal system, and skin. Skin lesions are detected in 20-40% of patients with acute or chronic HCV infection.

Classification
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Skin lesions that occur in the wake of HCV infection can be divided as follows.

Occurrence/Epidemiology
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About 3% of the world population is chronically infected with HCV. The prevalence in Germany is 0.3% of the population, in Mediterranean countries 2-3%, in some African countries up to 22%. Risk groups are i.v. drug addicts (85% are HCV positive), non-sterile piercings, HIV and/or HBV infected persons.

Clinical features
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Acute HC infections are asymptomatic in 75% of cases and symptomatic (icteric) in 25%. Symptomatic HCV infections heal spontaneously in half of the cases. Asymptomatic infections generally lead to a chronic course. 20% of patients with asymptomatic infection develop cirrhosis of the liver. There is an increased rate of liver cell carcinoma. HIV/HCV double infections often progress rapidly and are more often cholestatic.

Literature
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  3. Inamadar AC et al (2020) Necrolytic acral erythema: current insights. Clin Cosmet Investig Dermatol 13:275-281.

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  5. Halawani MR (2014)Dermatological manifestations of hepatitis C virus infection in Saudi Arabia. Saudi Med J 35:531-537.
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  8. Pinto-Almeida T et al (2013) Cutaneous lesions and finger clubbing uncovering hypocomplementemic urticarial vasculitis and hepatitis C with mixed cryoglobulinemia. An Bras Dermatol 88:973-976.
  9. Reyes-Avilés E et al (2015) Presence of Rheumatoid Factor during Chronic HCV Infection Is Associated with Expansion of Mature Activated Memory B-Cells that Are Hypo-Responsive to B-Cell Receptor Stimulation and Persist during the Early Stage of IFN Free Therapy. PLoS One 10:e0144629.
  10. Song J et al. (2016) Lack of evidence of hepatitis in patients with oral lichen planus in China: A case control study. Med Oral Patol Oral Cir Bucal 21:e161-e168.
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Last updated on: 13.02.2023