Talat Humaira, Wahid Zarnaz, Feroz Farheena, Sajid Madiha
Department of Dermatology, Dow University of Health Sciences, Dow Medical College, Karachi.
Department of Dermatology, Sindh Government Hospital, Liaquatabad, Karachi.
J Coll Physicians Surg Pak. 2017 Sep;27(9):S77-S79.
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.
对同时感染丙型肝炎病毒（HCV）的银屑病及其变体进行治疗很复杂。治疗选择有限，因为用于治疗重度银屑病的免疫抑制药物大多与终末器官损害尤其是肝毒性有关。另一方面，干扰素疗法有可能加重银屑病和银屑病关节炎。关于在这种情况下使用肿瘤坏死因子α（TNFα）抑制剂依那西普，有新的数据出现。尽管其成本和可及性限制了其使用；但当与用于HCV的干扰素疗法和利巴韦林联合使用时，已显示出良好效果。在此，我们报告一例28岁男性患者，患有红皮病型银屑病伴有关节病且同时感染HCV，该患者接受依那西普、聚乙二醇化干扰素和利巴韦林治疗成功。给予聚乙二醇化干扰素6个月，依那西普8个月。治疗结束时，不仅患者的HCV聚合酶链反应（PCR）检测不到，而且他的红皮病状态也有所改善。
