El Kassas Mohamed, Hegazy Osama Mo, Salah Eman M
Department of Endemic Medicine, Faculty of Medicine, Helwan University, Cairo 11795, Egypt.
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Helwan University, Cairo 11795, Egypt.
World J Hepatol. 2020 Oct 27;12(10):841-849. doi: 10.4254/wjh.v12.i10.841.
Hepatitis C virus (HCV) is a disease with a significant global impact, affecting approximately 2%-2.5% of the world's population. New direct-acting antivirals (DAAs) have been introduced over the past few years with great success in viral eradication. The association of chronic HCV infection with a wide spectrum of cutaneous manifestations has been widely reported in the literature.
To assess the effect of treating HCV with DAAs on the extrahepatic cutaneous manifestations of HCV.
This prospective observational study included 1039 HCV positive Egyptian patients who were eligible to receive DAAs. A total of 30 patients were diagnosed with extrahepatic cutaneous manifestations and fulfilled the inclusion criteria of the study. Of these patients, 6 had classic lichen planus, 8 were diagnosed with psoriasis vulgaris and 16 had pruritus. All patients received DAAs from October 2018 to July 2019 in the form of a three-month course of sofosbuvir/daclatasvir combination. Patients with lichen planus or psoriasis were dermoscopically evaluated before treatment and 6 mo after treatment, while patients with hepatic pruritus were assessed using the 12-Item Pruritus Severity Scale over the same period.
All patients with psoriasis showed significant improvement in all psoriatic plaques, and all patients with hepatic pruritus scored 0 on the 12-Item Pruritus Severity Scale indicating total improvement of pruritus. In addition, four of six patients with lichen planus showed complete improvement.
Treatment of HCV with DAAs was significantly effective in improving virus-related extrahepatic cutaneous manifestations.
丙型肝炎病毒（HCV）是一种对全球有重大影响的疾病，影响着世界约2%-2.5%的人口。在过去几年中，新型直接抗病毒药物（DAAs）已被引入，在根除病毒方面取得了巨大成功。慢性HCV感染与广泛的皮肤表现之间的关联在文献中已有广泛报道。
评估使用DAAs治疗HCV对HCV肝外皮肤表现的影响。
这项前瞻性观察性研究纳入了1039名符合接受DAAs治疗条件的埃及HCV阳性患者。共有30名患者被诊断为肝外皮肤表现并符合该研究的纳入标准。在这些患者中，6例患有经典扁平苔藓，8例被诊断为寻常型银屑病，16例有瘙痒症状。所有患者在2018年10月至2019年7月期间接受了三个月疗程的索磷布韦/达卡他韦组合形式的DAAs治疗。扁平苔藓或银屑病患者在治疗前和治疗后6个月接受皮肤镜评估，而肝性瘙痒患者在同一时期使用12项瘙痒严重程度量表进行评估。
所有银屑病患者的所有银屑病斑块均有显著改善，所有肝性瘙痒患者在12项瘙痒严重程度量表上的评分为0，表明瘙痒完全改善。此外，6例扁平苔藓患者中有4例显示完全改善。
使用DAAs治疗HCV对改善病毒相关的肝外皮肤表现有显著效果。
