RESUMEN
Background: Numerous extrahepatic disorders have been recognized in association with hepatitis C infection among which dermatological diseases occupy a central part. The true prevalence of these manifestations among hepatitis C infected patient and the role of HCV in the pathogenesis of these conditions has not been established in Egypt
Objectives: The aim of this study was to determine the prevalence of dermatological manifestations related to chronic hepatitis C infection in Egypt
Patients and methods: Three hundred and thirteen naive chronic hepatitis C patients were subjected to an interview questionnaire, clinical examination and laboratory tests including liver enzymes [alanine aminotransferase enzyme [ALT] and aspartate aminotransferase enzyme [AST], cryoglobulin, rheumatoid factor, bilirubin, prothrombin, HCV antibody, HCVRNA, blood sugar and liver biopsy if indicated
Results: Fifty-three patients [16.9%] were found to have dematological manifestations in the current study. The skin manifestations were xerostomia [8.3%], pruritis [4.0%], lichen planus [2.9%], psoriasis [2.2%], necrolytic acral erythema [1.4%], urticaria [1.4], vitiligo [ 1.1%], purpura [0.7%] and vasculitis [0.4%]. The mean age of patients [44.9+/-10.6 years] with dermatological manifestations was statistically significantly higher than that of patients [41.3 +/- 10.7] without dermatological manifestations. The percentages of patients with dermatological manifestations having HCV RNA positive were significantly lower [93.8%] than patients without dermatological manifestations [99.4%]. The dermatological manifestations [especially pruritus] were found with statistical significance more in patients with advanced fibrosis and cirrhosis [stages 3 and 4] [p: 0.04]. Otherwise there were no statistical significant differences found between both groups regarding other laboratory findings
Conclusion: Cutaneous manifestations may be the only, the earliest and the most apparent sign of the underlying HCV infection. so we recommend that the health care providers should screen for these diseases in patients with hepatitis C