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Mol Genet Metab 2018 Nov 28. Epub 2018 Nov 28.

Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address:

Porphyria Cutanea Tarda (PCT) is a cutaneous porphyria that results from the hepatic inhibition of the heme biosynthetic enzyme uroporphyrinogen decarboxylase (UROD), and can occur either in the absence or presence of an inherited heterozygous UROD mutation (PCT subtypes 1 and 2, respectively). A heterozygous UROD mutation causes half-normal levels of UROD activity systemically, which is a susceptibility factor but is not sufficient alone to cause type 2 PCT. In both Types 1 and 2 PCT, the cutaneous manifestations are precipitated by additional factors that lead to generation of an inhibitor that more profoundly reduces hepatic UROD activity. Read More

Diseases 2018 May 3;6(2). Epub 2018 May 3.

Department of Clinical and Surgical Sciences, University of Trieste, 34121 Trieste, Italy.

Introduction: The clinical and therapeutic management of mixed cryoglobulinemia (MC) remains a subject of controversy. In addition, most studies have not recorded the long-term follow-up and the outcome of these cases.

Material And Methods: We enrolled 246 patients affected by MC who were consecutively admitted to our Department from January 1993 to February 2013. Read More

Cochrane Database Syst Rev 2018 May 7;5:CD011403. Epub 2018 May 7.

Department of Nephrology, Hospital Universitari de Bellvitge, Feixa Illarga s/n, L'Hospitalet de Llobregat, Barcelona, Spain, 08907.

Background: Hepatitis C virus (HCV)-associated mixed cryoglobulinaemia is the manifestation of an inflammation of small and medium-sized vessels produced by a pathogenic IgM with rheumatoid factor activity generated by an expansion of B-cells. The immune complexes formed precipitate mainly in the skin, joints, kidneys or peripheral nerve fibres. Current therapeutic approaches are aimed at elimination of HCV infection, removal of cryoglobulins and also of the B-cell clonal expansions. Read More

Wiad Lek 2018;71(1 pt 1):64-72

Studia Doktoranckie, Zakład Farmakologii, Wydział Nauk o Zdrowiu, Uniwersytet Medyczny, Lublin.

Polyarteritis nodosa is a systemic necrotizing vasculitis which predominantly affects medium-sized arteries. It is a rare disease nowadays. Both the nomenclature and the classification of polyarteritis nodosa was amended several times in the past. Read More

Clin Rev Allergy Immunol 2018 Feb;54(1):177-184

Unité d'allergologie, Service d'immunologie et d'allergologie, Hôpitaux Universitaires de Genève HUG, Rue Micheli-du-Crest 24, CH-1211, Genève, Switzerland.

Recognition and timely adequate treatment of erythema multiforme remain a major challenge. In this review, current diagnostic guidelines, potential pitfalls, and modern/novel treatment options are summarized with the aim to help clinicians with diagnostic and therapeutic decision-making. The diagnosis of erythema multiforme, that has an acute, self-limiting course, is based on its typical clinical picture of targetoid erythematous lesions with predominant acral localization as well as histological findings. Read More

J Eur Acad Dermatol Venereol 2017 Aug 29;31(8):1260-1270. Epub 2017 Mar 29.

Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY, USA.

New all-oral direct-acting antivirals (DAA) have changed the hepatitis C virus (HCV) treatment landscape. Given that dermatologists frequently encounter HCV-infected patients, knowledge of the current treatment options and their utility in treating HCV-associated dermatologic disorders is important. In addition to highlighting the new treatment options, we review four classically HCV-associated dermatologic disorders - mixed cryoglobulinaemia (MC), lichen planus (LP), porphyria cutanea tarda (PCT) and necrolytic acral erythema (NAE) - and examine the role for all-oral direct-acting antiviral (DAA) regimens in their treatment. Read More

World J Gastroenterol 2017 Feb;23(5):743-750

Youssef Alhmada, Mohamed Hassan, Department of Pathology, University of Mississippi Medical Center, Jackson, MS 39216, United States.

In addition to its contributing role in the development of chronic liver diseases, chronic hepatitis C virus (HCV) infection is associated with extrahepatic manifestations, particularly, cutaneous-based disorders including those with pruritus as a symptom. Pruritus is frequently associated with the development of chronic liver diseases such as cholestasis and chronic viral infection, and the accumulation of bile acids in patients' sera and tissues as a consequence of liver damage is considered the main cause of pruritus. In addition to their role in dietary lipid absorption, bile acids can trigger the activation of specific receptors, such as the G protein-coupled bile acid receptor (GPBA/ TGR5). Read More

Actas Dermosifiliogr 2017 05 16;108(4):365-366. Epub 2017 Feb 16.

Servicio de Dermatología, Hospital Clínic, Barcelona, España.

Clin Lab 2016 Dec;62(12):2339-2348

Background: Chronic hepatitis C (CHC) infection causes a wide range of immune mediated hepatic and extrahepatic manifestations. Cutaneous manifestations constitute a major portion of the latter group. Host immune response to the virus - particularly regulatory T lymphocytes - is important in determining the outcome of the infection and the possibility of extrahepatic manifestations. Read More

J Adv Res 2017 Mar 2;8(2):99-111. Epub 2016 Dec 2.

Rheumatology and Clinical Immunology Unit, Department of Internal Medicine, Cairo University, Egypt.

Vasculitis is a remarkable presentation of the extrahepatic manifestations of HCV. According to the presence or absence of cryoglobulins it is subdivided into two main types: cryoglobulinemic vasculitis and non cryoglobulinemic vasculitis based on the attribution of vasculitis to serum cryoglobulins as a pathogenic factor. The attribution of cryoglobulinemia to HCV represents a success story in the history of immunology, microbiology, and clinical medicine. Read More

Rom J Morphol Embryol 2016 ;57(3):937-941

Discipline of Dermatology, Faculty of Medicine, "Grigore T. Popa" University of Medicine and Pharmacy, Clinic of Dermatovenereology, "St. Spiridon" Emergency Hospital, Iassy, Romania;

Autoimmunity is characterized by activation of the immune system that attacks and destroys wrongly, the body's own structures. All body tissues can be affected (erythrocytes, leukocytes, platelets, blood vessels, muscle tissue, endocrine system, and other), including the skin. Autoimmune diseases have an increased frequency in women, especially in adulthood, and they are associated with hereditary factors. Read More

Indian J Gastroenterol 2016 Nov 31;35(6):405-418. Epub 2016 Oct 31.

Department of Internal Medicine, UAB University of Alabama in Birmingham, Birmingham, AL, USA.

Porphyrias are a group of metabolic disorders, which result from a specific abnormality in one of the eight enzymes of the heme biosynthetic pathway. These have been subdivided based on the predominant site of enzyme defect into hepatic and erythropoietic types and based on clinical presentation into acute neurovisceral and cutaneous blistering porphyrias. This review focuses on hepatic porphyrias, which include acute intermittent porphyria (AIP), variegate porphyria (VP), hereditary coproporphyria (HCP), aminolevulinic acid dehydratase deficiency porphyria (ADP), and porphyria cutanea tarda (PCT). Read More

Vnitr Lek Fall 2016;62(9 Suppl 2):18-22

Extrahepatic manifestations of hepatitis C virus infection (HCV) are very common. The most common of these is mixed cryoglobulinaemia. Anti-HCV antibodies and viral ribonucleic acid, HCV RNA, can be found in the cryoprecipitates, together with the rheumatoid factor. Read More

Clin Transl Gastroenterol 2016 Jul 7;7(7):e179. Epub 2016 Jul 7.

Department of Organ System Interactions and Information, Saga Medical School, Saga, Japan.

Objectives: Oral lichen planus (OLP) is one of the extrahepatic manifestations of hepatitis C virus (HCV) infection. Presently developed interferon (IFN)-free direct-acting antivirals (DAAs) used to treat HCV infection have low side effect profiles and high efficacy. However, there are no studies examining the relationship between OLP and IFN-free DAAs. Read More

Dermatol Res Pract 2015 29;2015:182609. Epub 2015 Dec 29.

Faculty of Medicine, Clinical Pathology Department, Tanta University Hospitals, El Geish Street, Tanta, Gharbia Governorate 31111, Egypt.

Background. Hepatitis C is a global major health problem with extremely variable extrahepatic manifestations. Mixed cryoglobulinaemia (MC) shows a striking association with hepatitis C virus (HCV) infection, and it is sometimes asymptomatic. Read More

Rev Esp Quimioter 2016 Feb 19;29(1):44-6. Epub 2016 Jan 19.

María Pilar Ortega García, Servicio de Farmacia, Consorcio Hospital General Universitario de Valencia Av/Tres Cruces nº2 46014 Valencia, Spain.

An Bras Dermatol 2015 Nov-Dec;90(6):828-35

Universidade Federal de Mato Grosso, Cuiabá, MT, Brazil.

Background: Extrahepatic manifestations are seen in association with chronic infection by hepatitis B or C virus including cutaneous disorders. The frequency of these findings seems to vary among different places and reports. There is a lack of information about this issue in Brazil. Read More

World J Hepatol 2015 Nov;7(27):2740-8

Simone Garcovich, Rodolfo Capizzi, Department of Dermatology, Policlinico A. Gemelli, Catholic University of Sacred Heart, 00168 Rome, Italy.

The association of chronic hepatitis C virus (HCV) infection with a wide spectrum of cutaneous manifestations has been widely reported in the literature, with varying strength of epidemiological association. Skin diseases which are certainly related with chronic HCV infection due to a strong epidemiological and pathogenetic association are mixed cryoglobulinemia, lichen planus and porphyria cutanea tarda. Chronic pruritus and necrolytic acral erythema are conditions that may share a possible association with HCV infection, while several immune-mediated inflammatory skin conditions, such as psoriasis, chronic urticaria and vitiligo, have been only anecdotally reported in the setting of chronic HCV infection. Read More

Am J Ther 2016 Nov/Dec;23(6):e1965-e1967

Department of Medicine, New York Medical College, Metropolitan Hospital Center, New York, NY.

Hepatitis C infection and its treatment have been associated with extrahepatic manifestations, including different skin conditions. Over the past decades, a greater number of drugs have been implicated as triggers for drug-induced subacute cutaneous lupus erythematosus. We report a case of a 42-year-old Hispanic man who developed a forehead violaceous rash during treatment with pegylated interferon alpha-2a as part of his therapy against hepatitis C infection that subsequently resulted to be subacute cutaneous lupus erythematosus. Read More

Arab J Gastroenterol 2015 Sep-Dec;16(3-4):125-8. Epub 2015 Oct 30.

Department of Tropical Medicine and Infectious Diseases, Tanta University Faculty of Medicine, Tanta, Egypt.

Background And Study Aims: Chronic hepatitis C virus (HCV) is a major public health problem and represents a common cause of chronic liver disease worldwide. The Egyptian Demographic Health Survey (EDHS) has estimated HCV prevalence in Egypt to be 14.7%. Read More

J Clin Transl Hepatol 2015 Jun 15;3(2):127-33. Epub 2015 Jun 15.

Department of Medicine, Division of Gastroenterology-Hepatology, University of Connecticut Heath Center, Farmington, CT, USA.

Hepatitis C virus (HCV) affects millions of people worldwide, and an estimated 3.2 million people in the United States. HCV is a hepatotropic and lymphotropic virus that causes not only liver disease, but also a significant number of extrahepatic manifestations (EHMs). Read More

J Autoimmun 2015 Dec 29;65:74-81. Epub 2015 Aug 29.

Sorbonne Universités, UPMC Univ Paris 06, UMR 7211, and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), F-75005, Paris, France; INSERM, UMR_S 959, F-75013, Paris, France; CNRS, FRE3632, F-75005, Paris, France; AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology, F-75013, Paris, France. Electronic address:

In patients with infectious cryoglobulinemia vasculitis (CryoVas) in the absence of hepatitis C virus infection, data on presentation, therapeutic management and outcome are lacking. We conducted a nationwide survey that included patients with HCV-negative CryoVas. We describe here the presentation, therapeutic management and outcome of 18 patients with non-HCV infectious CryoVas and 27 additional patients identified form a systematic review of the literature. Read More

Gastroenterology 2015 Nov 28;149(6):1345-60. Epub 2015 Aug 28.

Department of Gastroenterology, Hepatology and Endocrinology, Medical School of Hannover, Hannover, Germany. Electronic address:

Chronic hepatitis C virus (HCV) infection is associated with several extrahepatic manifestations. Patients with HCV may develop mixed cryoglobulinemia and its sequelae, ranging from cutaneous and visceral vasculitis to glomerulonephritis and B-cell non-Hodgkin lymphoma. HCV-infected patients have increased rates of insulin resistance, diabetes, and atherosclerosis, which may lead to increased cardiovascular morbidity and mortality. Read More

Curr Infect Dis Rep 2015 Feb;17(2):452

Department of Medicine, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, 53792, USA,

There are several extrahepatic cutaneous manifestations associated with hepatitis B and hepatitis C virus infection. Serum sickness and polyarteritis nodosa are predominantly associated with hepatitis B infection, whereas mixed cryoglobulinemia associated vasculitis and porphyria cutanea tarda are more frequently seen in hepatitis C infection. The clinico-pathogenic associations of these skin conditions are not completely defined but appear to involve activation of the host immune system including the complement system. Read More

Semin Arthritis Rheum 2015 Apr 23;44(5):518-526. Epub 2014 Oct 23.

Rheumatology Unit, Medical School, University of Modena and Reggio Emilia, Modena, Italy; Policlinico di Modena, Azienda Ospedaliero-Universitaria, Modena, Italy.

Objective: Cryoglobulinemic vasculitis (CV) involving small- and medium-sized vessels is very frequently associated with hepatitis C virus and may be responsible for multiple organ involvement and skin ulcers (SU). Skin ulcers are often non-healing cutaneous lesions, possibly complicated by local infection and gangrene; they may severely affect the patients׳ quality of life and the overall prognosis. Therefore, the treatment of cryoglobulinemic SU is particularly challenging in the clinical practice. Read More

Ann Dermatol Venereol 2014 Dec;141 Suppl 4:S597-609

Département de dermatologie et allergologie, bâtiment des spécialités médicales, hôpitaux de Brabois, centre hospitalo-universitaire de Nancy, 54500 Vandœuvre-les-Nancy, France. Electronic address:

Dermatoses have been better characterized as hypochromic vitiligo in subjects with dark skin or the acquired racquet nails associated with hyperparathyroidism. The innate immunity has a central role in the new classification of auto inflammatory diseases, neutrophilic dermatoses, neutrophilic urticaria or pseudo-neutrophilic urticaria. Comorbidities have been studied e. Read More

FP Essent 2014 Dec;427:32-5

California Substance Abuse and Treatment Center, 900 Quebec Ave, Corcoran, CA 93212.

Chronic hepatitis C virus (HCV) infection is associated with multiple extrahepatic manifestations (EHM) affecting various organs in the body. Approximately 40% to 75% of patients with chronic HCV infection experience at least one clinical EHM during the course of the HCV infection. Mixed cryoglobulinemia (type 2) is the most documented EHM associated with chronic HCV infection. Read More

Springerplus 2014 26;3:559. Epub 2014 Sep 26.

Pharmacology, Royal College of Surgeons, London, UK ; Pharmacology and Toxicology Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt.

Introduction: Pulmonary arterial hypertension (PAH) is a serious complication of systemic sclerosis (SSc), has a dramatic impact on prognosis and survival and is a leading cause of death.

Case Description: A 40 years old female patient with difuse cutaneous SSc (dcSSc) presented with progressive dyspnea, choking sensation, cough, abdominal distension, constipation and dysphagia to solids. The muscle power was mildly reduced and multiple purpuric eruptions were present on the legs of variable sizes. Read More

Rev Pneumol Clin 2014 Dec 15;70(6):362-5. Epub 2014 Aug 15.

Service de médecine interne, hôpital militaire Moulay-Ismail, BP S15, Meknès, Maroc.

Induced sarcoïdosis during therapy with interferon for chronic viral hepatitis C involves mainly by isolated cutaneous lesions or with lung lesions. Systemic forms are very rare. We report an observation. Read More

J Dermatol Case Rep 2014 Jun 30;8(2):46-9. Epub 2014 Jun 30.

Eastern Virginia Medical School, Department of Dermatology, 721 Fairfax Avenue, Suite 200, Norfolk, VA, 23507, USA; ; Hampton University Skin of Color Research Institute, Hampton University, Hampton, VA, USA.

Background: Hepatitis C viral infection is a significant public health problem; 170 million persons are infected worldwide and the prevalence in the southern part of the United States exceeds two percent. Extrahepatic manifestations of hepatitis C viral infection are common; notably, 15-20% of patients will develop cutaneous manifestations of their disease. There are numerous dermatologic diseases associated with hepatitis C infection, including lichen planus, leukocytoclasticvasculitis, and porphyria cutaneatarda. Read More

Saudi Med J 2014 Jun;35(6):531-7

Department of Dermatology, College of Medicine and King Khalid University Hospital, PO Box 7805, Riyadh 11472, Kingdom of Saudi Arabia. Tel. +966 (11) 4691426. Fax. +966 (11) 4691432. E-mail:

The Saudi Ministry of Health data indicates that almost 32% of viral hepatitis cases were caused by hepatitis C virus (HCV). It has been widely reported that chronic HCV infection is associated with and may trigger or exacerbate many skin manifestations in 20-40% of patients visiting dermatologists. The most commonly encountered dermatological manifestations of HCV infection globally include mixed cryoglobulinemia, porphyria cutanea tarda, cutaneous and/or oral lichen planus, urticaria, pruritus, thrombocytopenic purpura, and psoriasis. Read More

Cutis 2014 Apr;93(4):185-7

Department of Dermatology, Venereology, and Allergology, Medical University of Gdańsk, Debinki St 7, 80-211 Gdańsk, Poland.

Abscesses related to drug use are the most common cutaneous manifestations among injection drug users, often occurring when the veins become less accessible. In these cases, other techniques may be used to administer drugs, such as skin popping (subcutaneous injection) or muscle popping (intramuscular injection). The main risk factors for abscess formation include skin popping, use of unsterilized needles, and injection of speedball (a mixture of cocaine and heroin). Read More

World J Gastroenterol 2014 Mar;20(11):2962-70

Deng-Ho Yang, Division of Rheumatology, Immunology and Allergy, Department of Internal Medicine, Taichung Armed-Forces General Hospital, Taichung 411, Taiwan.

During the course of chronic hepatitis C virus (HCV) infection, various extrahepatic manifestations of autoimmune disorders may occur, including arthralgia/arthritis, sicca complex, purpura, cutaneous ulcer, and thyroid dysfunction. In addition, the prevalence of circulating autoantibodies is high among patients with HCV infection. Commonly detected autoantibodies in HCV-infected patients include rheumatoid factor, antinuclear antibody, anti-SSA/anti-SSB antibody, cryoglobulin, antineutrophil cytoplasmic antibody, anti-smooth muscle antibody, anti-liver and anti-thyroid autoantibodies. Read More

Ann Hepatol 2014 Mar-Apr;13(2):293-6

Dipartimento di Scienze Mediche e Chirurgiche dell'Invecchiamento e Malattie Nefrologiche, Università di Bologna and Azienda Ospedaliero Universitaria, Policlinico Sant'Orsola Malpighi di Bologna, Italy.

For the last decade, the combination therapy of pegylated interferon (Peg-IFN) plus ribavirin (RBV) has been considered as the standard of care treatment for chronic hepatitis C virus (HCV) infection. However, it has been associated with an increased incidence of many adverse cutaneous reactions and emergence of autoantibodies or even autoimmune diseases. We report a case of irreversible alopecia universalis (AU) with complete hair loss extended to the whole body, which started after discontinuation of Peg-IFN/RBV combination therapy for chronic HCV infection. Read More

Int J Infect Dis 2014 Feb 6;19:93-4. Epub 2013 Dec 6.

Department of Medicine, Division of Nephrology and Hypertension, Rutgers, The State University of New Jersey, Newark, New Jersey, USA.

Chronic hepatitis C virus (HCV) infection is a complex, multi-organ disorder, not just limited to the liver. Mixed cryoglobulinemia (MC) type 2 is a common extrahepatic complication, in which immunoglobulin complexes deposit in vascular endothelium. This in turn creates a diffuse inflammatory reaction, leading to a variety of disorders involving multiple systems. Read More

Dermatology 2013 23;226(4):289-97. Epub 2013 Jul 23.

Division of Immunology and Allergology, University of Lausanne, Lausanne, Switzerland.

Sarcoidosis is a systemic granulomatous disorder of unknown origin commonly affecting the lung, the lymphoid system and the skin. We report here two cases of cutaneous sarcoidosis in two former intravenous drug users following interferon (IFN)-α and ribavirin therapy for chronic hepatitis C. Both patients developed skin sarcoidosis along venous drainage lines of both forearms, coinciding with the areas of prior drug injections. Read More

Autoimmun Rev 2013 Sep 24;12(11):1058-63. Epub 2013 Jun 24.

Chair and Rheumatology Unit, University of Modena and Reggio Emilia, Medical School, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy.

Objective: Systemic sclerosis (SSc) is an immune-mediated disorder characterized by multiple organ fibrotic alterations and diffuse microangiopathy. The SSc can be associated with other connective tissue diseases and less frequently with systemic vasculitides, including cryoglobulinemic vasculitis (CV). The aim of the present study was to investigate the prevalence of CV in a large series of SSc patients. Read More

Int J Artif Organs 2013 May 28;36(5):367-72. Epub 2013 Feb 28.

Division of Digestive Diseases, Maggiore Hospital, IRCCS Foundation, Milan, Italy.

Hepatitis C virus (HCV) infection may be associated with extra-hepatic illness including mixed cryoglobulinemia (MC). Consistent evidence exists on HCV-MC in the non-transplantation setting but information on HCV-related cryoglobulinemia after solid organ transplantation is limited, particularly after liver transplantation (LT). We report on a 48-year-old man who developed HCV-associated cryoglobulinemic vasculitis with recurrent hepatitis after liver transplant. Read More

Acta Gastroenterol Latinoam 2012 Dec;42(4):285-90

Universidad Federal de Bahia (UFBa), Bahia, Brasil.

Introduction: Hepatitis C is the major cause of liver transplantation and hepatocellular carcinoma and shows a global prevalence of 3%. Hepatitis C virus (HCV) is associated with extrahepatic manifestations (e.g. Read More

Rev Soc Bras Med Trop 2012 Dec;45(6):770-3

Universidade Federal do Triângulo Mineiro, Uberaba, MG.

While most of those infected with hepatitis C virus (HCV) are asymptomatic or only develop liver manifestations, a significant percentage evolves with autoimmune and lymphoproliferative disorders, resulting in a clinical condition called HCV syndrome. This work involving case studies of six patients with hepatitis C and varied skin manifestation aimed to report skin lesions occurring with HCV infection and its treatment. Skin manifestations in hepatitis C have been based on epidemiological studies. Read More

Blood 2012 Jun 3;119(25):5996-6004. Epub 2012 Apr 3.

Department of Internal Medicine, Groupe Hospitalier Pitié-Salpetrière, Assistance Publique des Hôpitaux de Paris, Université Pierre et Marie Curie, 47-83 Boulevard de l’Hôpital, Paris, France.

Data on the clinical spectrum and therapeutic management of noninfectious mixed cryoglobulinemia vasculitis (CryoVas) in the era of hepatitis C virus screening are lacking. We analyzed data from 242 patients with noninfectious mixed CryoVas included in the French multicenter CryoVas survey. Baseline manifestations were purpura (75%), peripheral neuropathy (52%), arthralgia or arthritis (44%), glomerulonephritis (35%), cutaneous ulcers (16%), and cutaneous necrosis (14%). Read More

J Hepatol 2012 Feb 30;56(2):455-63. Epub 2011 Aug 30.

Department of Internal Medicine, Assistance Publique-Hopitaux de Paris, Groupe Hospitalier Pitié-Salpêtrière, and Université Pierre et Marie Curie, Paris, France.

Dermatological adverse events (AEs) are an existing concern during hepatitis C virus (HCV) infection and peginterferon/ribavirin treatment. HCV infection leads to dermatological and muco-cutaneous manifestations including small-vessel vasculitis as part of the mixed cryoglobulinemic syndrome. Peginterferon/ribavirin treatment is associated with well-characterized dermatological AEs tending towards a uniform entity of dermatitis. Read More

Hepatogastroenterology 2011 May-Jun;58(107-108):880-6

Faculty of Medicine, Kuwait University, Jabriya, Kuwait.

Background/aims: It is well recognized that chronic hepatitis C infection causes liver disease ranging from mild chronic hepatitis to cirrhosis and hepatocellular carcinoma. Hepatitis C virus is also associated with extrahepatic manifestations that may be the first clinical presentation of infection. Cutaneous disease can constitute a significant part of the wide spectrum of extrahepatic abnormalities associated with Hepatitis C infection. Read More

Autoimmun Rev 2011 Nov 24;11(1):48-55. Epub 2011 Jul 24.

Rheumatology Unit, Department of Internal Medicine, University of Modena e Reggio Emilia, Medical School, Via del Pozzo 71, Modena, Italy.

Objective: Mixed cryoglobulinemia syndrome (MCs) is a systemic vasculitis characterized by multiple organ involvement due to the vascular deposition of immune-complexes, mainly the cryoglobulins. B-lymphocyte expansion represents the underlying pathological alteration frequently triggered by hepatitis C virus (HCV) infection. The treatment of MCs syndrome is generally based on antiviral drugs and/or immunosuppressors, among which rituximab, an anti-CD20 monoclonal antibody, has been usefully employed for both cutaneous and visceral MCs organ involvement. Read More

World J Gastrointest Pharmacol Ther 2010 Apr;1(2):72-4

Francesco Giuseppe Foschi, Anna Chiara Dall'Aglio, Arianna Lanzi, Giorgio Marano, Sara Savini, Giuseppe Francesco Stefanini, Department of Internal Medicine, Faenza Hospital,Viale Stradone 9, 48018 Faenza (RA), Italy.

Hepatitis C virus (HCV) infection affects about 3% of the world's population and often leads to chronic liver disease. In some industrialized countries, HCV prevalence increases with age, but the optimal management of older patients has not been accurately defined. HCV infection can also lead to lymphoproliferative disorders, the most common being mixed cryoglobulinemia (MC), and also for this condition that frequently affects elderly patients, the optimal therapeutic strategy is still debated. Read More

Hepatol Int 2011 Dec 20;5(4):934-40. Epub 2011 Mar 20.

Department of Virology, National Institute of Public Health, National Institute of Hygiene, 24, Chocimska Street, 00-791, Warsaw, Poland.

Purpose: The aim of this study was to analyze histopathological changes in the liver and serum inflammatory cytokine level in hepatitis C virus (HCV)-infected patients with and without cryoglobulinemia.

Methods: The study group consisted of 34 patients with chronic hepatitis C, confirmed by serological and virological markers. Ten out of 34 patients had cryoglobulinemia. Read More

Acta Cytol 2010 Sep-Oct;54(5 Suppl):863-6

Department of Pathology, New York University School of Medicine, New York, New York 10016, USA.

Background: Sarcoidosis is an autoimmune disease of unknown origin characterized by the presence of noncaseating epithelioid cell granulomas in multiple organs. Sarcoidosislike lesions have been reported in patients who have a history of chronic hepatitis C with interferon treatment.

Case: A case of cutaneous sarcoidosis, clinically presenting with multiple skin nodules, occurred in a woman with a history of relapsed chronic hepatitis C with interferon therapy. Read More

Acta Derm Venereol 2010 Sep;90(5):531-2

Ann Dermatol Venereol 2010 Mar 20;137(3):220-4. Epub 2010 Feb 20.

Service de dermatologie, CHIC de Cornouaille, 29000 Quimper, France.

Introduction: Periarteritis nodosa (PAN) is a form of vasculitis affecting the small and medium-sized arteries. Below, we report a case of cutaneous PAN relapsing in streptococcal infections over a period of 30 years and progressing towards systemic vasculitis.

Case Report: A 35-year-old man was hospitalised for a retro-pharyngeal access associated with fever, arthralgia, myalgia and inflammatory subcutaneous nodules. Read More

Eur J Gastroenterol Hepatol 2010 Aug;22(8):967-72

Department of Internal Medicine, Université Claude Bernard Lyon, 1 place de l'Hôpital, Lyon Cedex, France.

Unlabelled: BASIC: To describe the main characteristics and treatment of sarcoidosis in patients with chronic hepatitis C virus (HCV) infection.

Methods: Retrospective cohort study of patients with chronic HCV infection and sarcoidosis at our tertiary institution.

Results: Eleven cases (eight women, three men) fulfilled the criteria for sarcoidosis. Read More