Dermatologic disorders associated viral hepatitis in Egypt

ABSTRACT

Subjective Viral hepatitis can present with a wide variety of cutaneous manifestations. Of all bloodborne infections, hepatitis has the greatest chance for accidental transmission through breaks in the skin during surgical procedures, needle pricks, etc. The aim of this work is to study the cutaneous manifestations of viral hepatitis in Egypt. Also to booster the dermatologist awareness of the various associations, so that an early diagnosis of and precautions against such a serious disorder could be undertaken. Patients and Hepatitis patients were taken at random from the inpatient and outpatient clinics of the university hospitals and liver institute in Egypt. The patients had complete history taking, physical and dermatological examination. Hepatitis serology, blood chemistry for liver functions, lipids, diabetes, and kidney function, skin biopsy, bacterial and mycological culture were done for the patients as indicated. 900 hepatitis patients [520 males, 380 females] were examined. Of them, 500 had Hepatitis C virus [HCV] and 400 had Hepatitis B virus [HBV] infection. 60% were patients residing in rural regions, and 55.5% were workers and farmers infested with Bilharzia. 15% gave different histories of blood transfusion, [27.7%] I.V. drug administration specially for Bilharziasis, and 5.5% were in contact with other hepatitis patients. Skin manifestations of liver disease as a whole comprised 48.1% of the total, and 6.1% had skin manifestations of hepatitis. 80% had skin manifestations with HCV, and 20% with HBV infection. The most prevalent diseases were lichen planus, urticaria, erythema multiforme, psoriasis, leucocytoclastic vasculitis, and erythema nodosum. Viral hepatitis is a prevalent infectious disease in Egypt, the commonest types being HCV and HBV most probably as a result of repeated I.V. treatment of Bilharzial patients. Male workers outnumbered females. Skin diseases occurred more with HCV patients. Not all types of the reported skin associations were found in this study, and there has not been a previous report about the prevalence of associated skin disorders in Egypt for comparison. However, a wider scale study is required for a more precise evaluation. Dermatologists should be aware of the various cutaneous associations of such a serious disease