İmran HASANOĞLU, Şiran KESKE, Mehmet TAŞYARAN, Rahmet GÜNER

Pityriasis rosea associated with pegylated interferon alfa and ribavirin treatment in a patient with chronic hepatitis C

Background: Pityriasis rosea is an acute inflamatory skin disease that the etiology is unknown but some viral agents like human herpes virus-6 and 7 and drugs are suspected. Case report: A-58-year-old man with chronic hepatitis C was being followed up in our hospital. Pegylated interferon (PEG-IFN) alfa-2b (100 μg per week) and ribavirin (1000 mg/day) was started. In the third month of this treatment, the patient was diagnosed with pityriasis rosea (PR), which was confirmed by skin biopsy. PEG-IFN alfa-2b treatment for chronic hepatitis C was maintained and no therapy was given for PR. The lesions spontaneously improved within 5 weeks. Conclusion: Interferon and ribavirin have several cutaneous side effects. Our case is the first case of PR, emerged in a patient with chronic hepatitis C while receiving PEG-IFN alfa 2b and ribavirin.

PDF

___

1. Asian Pacific Association for the Study of the Liver (APASL) Hepatitis C Working Party, McCaughan GW, Omata M, Amarapurkar D, Bowden S, Chow WC, et al. Asian Pacific Association for the Study of the Liver consensus statements on the diagnosis, management and treatment of hepatitis C virus infection. J Gastroenterol Hepatol 2007;22:615-33.
2. Dalekos GN, Hatzis J, Tsianos EV. Dermatologic disease during interferon-alpha therapy for chronic viral hepatitis. Ann Intern Med 1998;128:409-10.
3. Dalekos GN, Christodoulou D, Kistis KG, Zervou EK, Hatzis J, Tsianos EV. A prospective evaluation of dermatological side-effects during alpha-interferon therapy for chronic viral hepatitis. Eur J Gastroenterol Hepatol 1998;10:933-9.
4. Simsek H, Savas C, Akkiz H, Telatar H. Interferon-induced vitiligo in a patient with chronic viral hepatitis C infection. Dermatology 1996;193:65-6.
5. Fried MW. Side effects of therapy of hepatitis C and their management. Hepatology 2002;36(Suppl 1):S237-44.
6. Shiffman ML. Side effects of medical therapy for chronic hepatitis C. Ann Hepatol 2004;3:5-10.
7. Fantini F, Padalino C, Gualdi G, Monari P, Giannetti A. Cutaneous lesions as initial signs of interferon alpha-induced sarcoidosis:report of three new cases and review of the literature. Dermatol Ther 2009;22(Suppl 1):S1-7.
8. Goksugur N, Karabay O. Eyelash and eyebrow trichomegaly induced by interferon-alfa 2a. Clin Exp Dermatol 2007;32:583-4.
9. Guner R, Yapar D, Sarici M, Tasyaran MA. Pegileinterferon alfa-2b enjeksiyonuna bağlı kutanöz nekroz:Olgu sunumu. Viral Hepatit Derg 2010;16:77-9.
10. Gurbuz Y, Tutuncu EE, Ozturk DB, Baylak A, Sencan I. Kronik hepatit C tedavisini takiben gelişen cilt bulguları;iki olgu sunumu. Viral Hepatit Derg 2011;17:84-7.
11. Drago F, Broccolo F, Rebora A. Pityriasis rosea:an update with a critical appraisal of its possible herpesviral etiology. J Am Acad Dermatol 2009;61:303-18.
12. Canpolat Kirac B, Adisen E, Bozdayi G, Yucel A, Fidan I, Aksakal N, et al. The role of human herpesvirus 6, human herpesvirus 7, Epstein-Barr virus and cytomegalovirus in the aetiology of pityriasis rosea. J Eur Acad Dermatol Venereol 2009;23:16-21.
13. González LM, Allen R, Janniger CK, Schwartz RA. Pityriasis rosea:an important papulosquamous disorder. Int J Dermatol 2005;44:757-64.
14. Durusoy C, Alpsoy E, Yilmaz E. Pityriasis rosea in a patient with Behçet’s disease treated with interferon alpha 2A. J Dermatol 1999;26:225-8.
15. Berk DR, Mallory SB, Keeffe EB, Ahmed A. Dermatologic disorders associated with chronic hepatitis C:effect of interferon therapy. Clin Gastroenterol Hepatol 2007;5:142-51.
16. Tursen U, Kaya TI, Kokturk A, Dusmez D. Lichenoid photodermatitis associated with nimesulide. Int J Dermatol 2001;40:767-8.
17. Drago F, Rebora A. Treatments for pityriasis rosea. Skin Therapy Lett 2009;14:6-7.
18. Rassai S, Feily A, Sina N, Abtahian S. Low dose of acyclovir may be an effective treatment against pityriasis rosea:a random investigator-blind clinical trial on 64 patients. J Eur Acad Dermatol Venereol 2011;25:24-6.
19. Lim SH, Kim SM, Oh BH, Ko JH, Lee YW, Choe YB, et al. Lowdose Ultraviolet A1 Phototheraphy for Treating Pityriasis Rosea. Ann Dermatol 2009;21:230-6.