Erythrodermic Psoriasis and Hepatitis C Infection Treated with Pegylated Interferon and Anti-TNFα α(Etanercept) Therapy.

Treatment of psoriasis and its variants with concomitant hepatitis C virus (HCV) infection is complex. The treatment options are limited because the immunosuppressive drugs used for managing severe psoriasis are mostly associated with end-organ damage particularly hepatotoxicity. On the other hand, Interferon therapy has the potential to exacerbate psoriasis and psoriatic arthropathy. There is emerging data regarding the use of etanercept, a TNFα inhibitor in such cases. Though its cost and availability limits its use; but when combined with Interferon therapy and ribavirin for HCV, it has shown good results. Here, we report a case of 28-year male, suffering from erythrodermic psoriasis with arthropathy and concomitant HCV infection, who was successfully treated with etanercept and pegylated interferon and ribavirin. Pegylated interferon was given for 6 months and etanercept for 8 months. At the end of the therapy, not only the patient's polymervese chain reaction (PCR) for HCV became undetectable, but his erytherodermic state also improved.