What is the etiology of neuropathic flexion deformities of the fingers and dry, scaling palms related to hepatitis C infection?—MARY CARTER, CANP, Penrose, Calif.
Several dermatologic manifestations of hepatitis C infection have been described. These manifestations include pruritus, porphyria cutanea tarda, cryoglobulinemia and vasculitis, salivary gland lesions (lymphocytic capillaritis and lymphocytic sialadenitis), lichen planus, polyarteritis nodosa, urticaria, erythema nodosum, and erythema multiforme (Int J Dermatol. 1997;36:251-254).
Combination therapy with interferon alpha-2b plus ribavirin for 24 to 48 hours has been used as initial treatment for chronic hepatitis C infection. Either agent, when used individually, can cause dermatologic side effects. Several reports of eczema have been described in patients with hepatitis C infection who were treated with interferon alpha-2b and ribavirin (Arch Dermatol. 2004;140:215-217; available at archderm.jamanetwork.com/article.aspx?articleid=480239, accessed December 15, 2013). A literature search does not reveal any citations for the symptoms described by Ms. Carter.—Philip R. Cohen, MD (183-4)
These are letters from practitioners around the country who want to share their clinical problems and successes, observations and pearls with their colleagues. We invite you to participate. If you have a clinical pearl, submit it here.