1
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Efficacy and safety of ropeginterferon alfa-2b in Japanese patients with polycythemia vera: an open-label, single-arm, phase 2 study. Int J Hematol 2022; 116:215-227. [DOI: 10.1007/s12185-022-03341-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 03/23/2022] [Accepted: 03/28/2022] [Indexed: 10/18/2022]
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2
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Abstract
Eczematous drug eruptions are a heterogenous group of skin reactions that resemble eczema both clinically and histologically. We reviewed the literature and cataloged the systemically administered medications that cause these eruptions, along with their characteristic clinical presentations. We identified three primary pathophysiologic etiologies: (1) cutaneous immunomodulation, (2) skin dehydration, and (3) delayed hypersensitivity. Notably, eczematous eruptions caused by altered immunity in the skin may be increasing in incidence as some responsible drugs, in particular biologic therapies (such as tumor necrosis factor-α and interleukin-17 inhibitors) and targeted cancer treatments (including immune checkpoint inhibitors and epidermal growth factor receptor inhibitors), become more commonly employed in clinical practice. Other notable causes of eczematous eruptions include antiviral agents for hepatitis C virus and cardiovascular medications in elderly individuals, and notable subtypes of eczematous reactions include systemic contact dermatitis and photoallergic reactions, which are also discussed. The diagnostic gold standard is drug rechallenge and most reactions may be treated effectively with emollients, topical corticosteroids, and oral antihistamines.
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Affiliation(s)
| | - Susan Burgin
- Harvard Medical School, Boston, MA, USA.
- Department of Dermatology, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA, 02115, USA.
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3
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Martinez-Lopez A, Cuenca-Barrales C, Montero-Vilchez T, Molina-Leyva A, Arias-Santiago S. Review of adverse cutaneous reactions of pharmacologic interventions for COVID-19: A guide for the dermatologist. J Am Acad Dermatol 2020; 83:1738-1748. [PMID: 32777318 PMCID: PMC7413159 DOI: 10.1016/j.jaad.2020.08.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/27/2020] [Accepted: 08/01/2020] [Indexed: 12/15/2022]
Abstract
The new coronavirus, severe acute respiratory syndrome coronavirus 2, is associated with a wide variety of cutaneous manifestations. Although new skin manifestations caused by COVID-19 are continuously being described, other cutaneous entities should also be considered in the differential diagnosis, including adverse cutaneous reactions to drugs used in the treatment of COVID-19 infections. The aim of this review is to provide dermatologists with an overview of the cutaneous adverse effects associated with the most frequently prescribed drugs in patients with COVID-19. The skin reactions of antimalarials (chloroquine and hydroxychloroquine), antivirals (lopinavir/ritonavir, ribavirin with or without interferon, oseltamivir, remdesivir, favipiravir, and darunavir), and treatments for complications (imatinib, tocilizumab, anakinra, immunoglobulins, corticosteroids, colchicine and low molecular weight heparins) are analyzed. Information regarding possible skin reactions, their frequency, management, and key points for differential diagnosis are presented.
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Affiliation(s)
- Antonio Martinez-Lopez
- Dermatology Unit, Virgen de las Nieves University Hospital, Granada, Spain,TECe19–Clinical and Translational Dermatology Investigation Group, Instituto Biosanitario, Granada, Spain
| | - Carlos Cuenca-Barrales
- TECe19–Clinical and Translational Dermatology Investigation Group, Instituto Biosanitario, Granada, Spain
| | | | - Alejandro Molina-Leyva
- Dermatology Unit, Virgen de las Nieves University Hospital, Granada, Spain; TECe19-Clinical and Translational Dermatology Investigation Group, Instituto Biosanitario, Granada, Spain.
| | - Salvador Arias-Santiago
- Dermatology Unit, Virgen de las Nieves University Hospital, Granada, Spain,TECe19–Clinical and Translational Dermatology Investigation Group, Instituto Biosanitario, Granada, Spain,Dermatology Department, University of Granada, Granada, Spain
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4
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Tawfik YM, Hassany SM, Badran AY, El-Gazzar AF, Alemam MF, Sayed DS. Hepatitis C virus associated skin manifestations in upper Egypt: Before and after direct acting antiviral treatment. Dermatol Ther 2020; 33:e14365. [PMID: 33001546 DOI: 10.1111/dth.14365] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/14/2020] [Accepted: 09/27/2020] [Indexed: 12/27/2022]
Abstract
Egypt displays a high-hepatitis C virus (HCV) burden and almost 20% of the patients develop cutaneous manifestations HCV-related. Direct acting antivirals (DAAs) drastically changed HCV patient's morbidity and mortality but their impact of the cutaneous manifestations remains elusive. Our aim was to find out the prevalence of different dermatological manifestations accompaning HCV infection in Egyptian patients. Also, to highlight the impact of DAAs on such manifestations and any potential dermatological side effects. A descriptive study was carried out at the Department of Tropical medicine and Gastroenterology in collaboration with the Department of Dermatology, Venerology and Andrology, Assiut University Hospitals. Medical history, full general, dermatological examination and photography were performed for all patients before the start of treatment with the full regimen of DAAs, every month and 3 months after reaching sustained virological response (SVR), and the changes of skin lesions were recognized and rated by two blinded dermatologists. Out of 1000 examined patient, 36.9% had skin manifestation. Itching was the commonenst presented in 190 patients (51.5%). Three months after reaching SVR, skin examination revealed improvement in the majority of patients (23 764.22%). Pruritis had significant clinical improvement in 152(80%) of patients with significant change in the Visual Analog Score (P = .000). Also, patients with both cutaneous vasculitis and eczema experienced improvement in their skin manifestations. Skin manifestations are common in Egyptian patients with HCV infection. Pruritis is the commonest. The use of DAAs in treatment of HCV is associated with significant improvement of skin lesions with very limited cutaneous adverse effects.
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Affiliation(s)
- Yasmin Mostafa Tawfik
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Assuit University, Assuit, Egypt
| | - Sahar M Hassany
- Department of Tropical medicine and Gastroenterology, Faculty of Medicine, Assuit University, Assuit, Egypt
| | - Aya Y Badran
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Assuit University, Assuit, Egypt
| | - Amira F El-Gazzar
- Department of Public Health and Community Medicine, Assiut University, Assuit, Egypt
| | - Mohamed F Alemam
- Department of Clinical pathology, Quena faculty of Medicine, South Valley University, South Valley University, Qena, Egypt
| | - Doaa S Sayed
- Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Assuit University, Assuit, Egypt
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5
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Damiani G, Franchi C, Pigatto P, Altomare A, Pacifico A, Petrou S, Leone S, Pace MC, Fiore M. Outcomes assessment of hepatitis C virus-positive psoriatic patients treated using pegylated interferon in combination with ribavirin compared to new Direct-Acting Antiviral agents. World J Hepatol 2018; 10:329-336. [PMID: 29527268 PMCID: PMC5838451 DOI: 10.4254/wjh.v10.i2.329] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 12/18/2017] [Accepted: 01/24/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the outcomes in biological treatment and quality of life of psoriatic patients with chronic hepatitis C (CHC) treated with new Direct-Acting Antiviral agents (DAAs) compared to pegylated interferon-2α plus ribavirin (P/R) therapy.
METHODS This is a retrospective study involving psoriatic patients in biological therapy who underwent anti-hepatitis C virus (HCV) treatment at the Department of Dermatology Galeazzi Orthopaedic Institute Milan, Italy from January 2010 to November 2017. The patients were divided into two groups: patients that underwent therapy with DAAs and patients that underwent HCV treatment with P/R. Patients were assessed by a dermatologist for psoriasis symptoms, collecting Psoriasis Area Severity Index (PASI) scores and the Dermatology Quality of Life Index (DLQI). PASI and DLQI scores were evaluated 24 wk after the end of HCV treatment and were assumed as an outcome of the progression of psoriasis. Switching to a different bDMARD was considered as an inadequate response to biological therapy. The dropout of HCV therapy and sustained virological response (SVR) were considered as outcomes of HCV therapy.
RESULTS Fifty-nine psoriatic patients in biological therapy underwent antiviral therapy for CHC. Of this, 27 patients were treated with DAAs and 32 with P/R. After 24 wk post treatment, the DLQI and the PASI scores were significantly lower (P < 0.001 and P < 0.005, respectively) in the DAAs group compared with P/R group. None of the patients in the DAAs group (0/27) compared to 8 patients of the P/R group (8/32) needed a shift in biological treatment.
CONCLUSION DAAs seem to be more effective and safe than P/R in HCV-positive psoriatic patients on biological treatment. Fewer dermatological adverse events may be due to interferon-free therapy.
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Affiliation(s)
- Giovanni Damiani
- Study Center of Young Dermatologists Italian Network (YDIN), Gised, Bergamo, Italy and Clinical Dermatology, IRCCS Galeazzi Orthopaedic Institute, Milan 20126, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan 20126, Italy
| | - Chiara Franchi
- Clinical Dermatology, IRCCS Galeazzi Orthopaedic Institute, Milan 20126, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan 20126, Italy
| | - Paolo Pigatto
- Clinical Dermatology, IRCCS Galeazzi Orthopaedic Institute, Milan 20126, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan 20126, Italy
| | - Andrea Altomare
- Clinical Dermatology, IRCCS Galeazzi Orthopaedic Institute, Milan 20126, Italy
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan 20126, Italy
| | - Alessia Pacifico
- San Gallicano Dermatological Institute, IRCCS, Rome 00144, Italy
| | - Stephen Petrou
- Department of Emergency Medicine, St. George’s University Medical School, Grenada, West Indies
| | - Sebastiano Leone
- Division of Infectious Diseases, “San Giuseppe Moscati” Hospital, Avellino 83100, Italy
| | - Maria Caterina Pace
- Department of Anesthesiological, Surgical and Emergency Sciences, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
| | - Marco Fiore
- Department of Anesthesiological, Surgical and Emergency Sciences, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
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6
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Vale EPBMD, Rodrigues CHL, Kallas FE, Fucuta PDS. Eczema craquelé associated with antiviral treatment for chronic hepatitis C. An Bras Dermatol 2017; 92:436-437. [PMID: 29186272 PMCID: PMC5514600 DOI: 10.1590/abd1806-4841.20174464] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Accepted: 04/09/2015] [Indexed: 12/01/2022] Open
Affiliation(s)
| | - Carlos Henrique Lima Rodrigues
- Gastroenterology and Hepatology Unit - Hospital de Base da Faculdade de Medicina de São José do Rio Preto (FAMERP) - São José do Rio Preto (SP), Brazil
| | - Fábio Esper Kallas
- Department of Clinical Surgery - Santa Casa de Misericórdia de Passos - Passos (MG), Brazil
| | - Patricia da Silva Fucuta
- Gastroenterology and Hepatology Unit - Hospital de Base da Faculdade de Medicina de São José do Rio Preto (FAMERP) - São José do Rio Preto (SP), Brazil
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7
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Scavone C, Sportiello L, Rafaniello C, Mascolo A, Sessa M, Rossi F, Capuano A. New era in treatment options of chronic hepatitis C: focus on safety of new direct-acting antivirals (DAAs). Expert Opin Drug Saf 2016; 15:85-100. [DOI: 10.1080/14740338.2016.1221396] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Cristina Scavone
- Department of Experimental Medicine, Section of Pharmacology, Second University of Naples, Naples, Italy
| | - Liberata Sportiello
- Department of Experimental Medicine, Section of Pharmacology, Second University of Naples, Naples, Italy
| | - Concetta Rafaniello
- Department of Experimental Medicine, Section of Pharmacology, Second University of Naples, Naples, Italy
| | - Annamaria Mascolo
- Department of Experimental Medicine, Section of Pharmacology, Second University of Naples, Naples, Italy
| | - Maurizio Sessa
- Department of Experimental Medicine, Section of Pharmacology, Second University of Naples, Naples, Italy
| | - Francesco Rossi
- Department of Experimental Medicine, Section of Pharmacology, Second University of Naples, Naples, Italy
| | - Annalisa Capuano
- Department of Experimental Medicine, Section of Pharmacology, Second University of Naples, Naples, Italy
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8
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Verma P, Dayal S, Jain VK, Amrani A. Alopecia universalis as a side effect of pegylated interferon α-ribavirin combination therapy for hepatitis C: a rare case report. J Chemother 2016; 29:380-382. [PMID: 27741937 DOI: 10.1080/1120009x.2016.1245235] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Pegylated interferon α and ribavirin therapy is associated with increased incidence of various systemic and cutaneous side effects. Among the side effects of this therapy, alopecia universalis is a rarely reported side effect which causes significant cosmetic concern to the patient. We report a rare case of alopecia universalis which developed eight weeks after discontinuation of this antiviral combination therapy. This gains importance because it is essential to sensitize the treating gastroenterologist and the dermatologist regarding this rare side effect.
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Affiliation(s)
- Poonam Verma
- a Department of Dermatology , Pt. B.D.Sharma, PGIMS , Rohtak , India
| | - Surabhi Dayal
- a Department of Dermatology , Pt. B.D.Sharma, PGIMS , Rohtak , India
| | - V K Jain
- a Department of Dermatology , Pt. B.D.Sharma, PGIMS , Rohtak , India
| | - Ashish Amrani
- a Department of Dermatology , Pt. B.D.Sharma, PGIMS , Rohtak , India
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9
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Lemmenmeier E, Gaus B, Schmid P, Hoffmann M. A case of erythrodermia from exacerbated psoriasis vulgaris due to treatment of acute hepatitis C. BMC DERMATOLOGY 2016; 16:5. [PMID: 27230122 PMCID: PMC4881008 DOI: 10.1186/s12895-016-0042-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Accepted: 05/17/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Skin side effects during interferon-alpha and ribavirin treatment are common, but autoimmune dermatosis triggered by interferon-alpha is rare. We describe a case of erythrodermia from exacerbated psoriasis during the treatment of acute hepatitis C with pegylated-interferon-alpha and ribavirin. The incidence of psoriasis in this circumstance is unknown and only 36 cases are described in the literature, of which only one describes an erythrodermic psoriasis flare. CASE PRESENTATION A 50-years old healthy white man presented with the complaints of headache, muscle pain, appetite loss, yellow skin complexion and fatigue. The laboratory results showed elevated liver enzymes above 50 times the upper limit of normal and a positive antibody test and RNA for hepatitis C. A screening test 6 months earlier was negative and therefore the diagnosis of an acute hepatitis C infection was most likely. In the absence of spontaneous clearance of the virus a therapy with pegylated- interferon-α and ribavirin was initiated. After 3 weeks the patient developed red scaly papular skin lesions that evolved despite treatment with prednisone to a severe erythrodermia. A skin biopsy showed typical signs for psoriasis vulgaris. Treatment with steroids was intensified and the hepatitis C therapy stopped. The patient achieved sustained virological response for hepatitis C, but psoriatic lesions were still present 6 months after treatment. CONCLUSION Although autoimmune skin reactions under pegylated-interferon-α and ribavirin treatment are rare it is important to recognise them early to start an adequate treatment to guarantee hepatitis C treatment continuation.
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Affiliation(s)
- Eva Lemmenmeier
- Division of Infectious Diseases and Hospital Hygiene, Cantonal Hospital St.Gallen, Rorschacherstrasse 95, 9007, St.Gallen, Switzerland.
| | - Barbara Gaus
- Department of Dermatology, Cantonal Hospital St.Gallen, Rorschacherstrasse 95, 9007, St.Gallen, Switzerland
| | - Patrick Schmid
- Division of Infectious Diseases and Hospital Hygiene, Cantonal Hospital St.Gallen, Rorschacherstrasse 95, 9007, St.Gallen, Switzerland
| | - Matthias Hoffmann
- Division of Infectious Diseases and Hospital Hygiene, Cantonal Hospital St.Gallen, Rorschacherstrasse 95, 9007, St.Gallen, Switzerland
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10
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Ribavirin. MEYLER'S SIDE EFFECTS OF DRUGS 2016. [PMCID: PMC7151912 DOI: 10.1016/b978-0-444-53717-1.01403-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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11
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Falcão EMM, Trope BM, Godinho MM, Carneiro LH, de Araujo-Neto JM, Nogueira CAV, Ramos-E-Silva M. Cutaneous Eruption due to Telaprevir. Case Rep Dermatol 2015; 7:253-62. [PMID: 26500538 PMCID: PMC4612548 DOI: 10.1159/000439264] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Hepatitis C virus (HCV) chronically infects 0.5–3% of the world population. A large group of patients develop cirrhosis and its complications. Since 2011, telaprevir and boceprevir are used, improving the disease evolution. One of the main side effects of these drugs is skin eruption. We report a 53-year-old patient with cirrhosis due to HCV who started the classic treatment associated with telaprevir. In the ninth week, he presented a severe rash that required the interruption of this drug. We emphasize the importance of early recognition and appropriate management of adverse skin reaction.
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Affiliation(s)
| | - Beatriz Moritz Trope
- Sector of Dermatology and Post-Graduation Course, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mariana Marteleto Godinho
- Sector of Dermatology and Post-Graduation Course, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Leonardo Hoehl Carneiro
- Sector of Pathology, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - João Marcello de Araujo-Neto
- Sector of Medical Clinics, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cristiane Alves Villela Nogueira
- Sector of Medical Clinics, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcia Ramos-E-Silva
- Sector of Dermatology and Post-Graduation Course, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Turker K, Tas B, Ozkaya M, Tas E, Caglar A, Tetikkurt US. Dystrophic-Anagen Effluvium Occurring During Pegylated Interferon-α-2a/Ribavirin Therapy. HEPATITIS MONTHLY 2015; 15:e24804. [PMID: 25821474 PMCID: PMC4360537 DOI: 10.5812/hepatmon.24804] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Revised: 01/26/2015] [Accepted: 02/04/2015] [Indexed: 12/11/2022]
Abstract
INTRODUCTION Various types of dermatological manifestations have been reported due to hepatitis C virus (HCV) infection and anti-HCV therapy. Some of them have been described during IFN-based therapies. PEG-IFN-α-2a/RBV combination is used as the international standard of treatment for HCV infection for a long time. The combination therapy yields an adverse-event profile similar to standard interferon (IFN) therapy. Some of these adverse effects are rheumatologic, neuropsychiatric and dermatological manifestations including alopecia. CASE PRESENTATION We reported a 43-year-old woman with dystrophic anagen effluvium (DAE), rheumatoid arthritis and Hashimoto thyroiditis, which were developed under the combination therapy for chronic HCV infection. CONCLUSIONS Although some cases of alopecia areata (AA) and telogen effluvium (TE) were reported in literature, no case of DAE associated with PEG-INF-α-2a /RBV combination therapy was reported previously.
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Affiliation(s)
- Kamuran Turker
- Department of Infectious Diseases, Ministry of Health Bagcilar State Hospital, Istanbul, Turkey
- Corresponding Author: Kamuran Turker, Department of Infectious Diseases, Ministry of Health Bagcilar State Hospital, Istanbul, Turkey. Tel: +90-2124404000, Fax: +90-2124404242, E-mail:
| | - Betul Tas
- Department of Dermatology, Ministry of Health Bagcilar State Hospital, Istanbul, Turkey
| | - Murat Ozkaya
- Department of Physical Medicine and Rehabilitation, Ministry of Health Bagcilar State Hospital, Istanbul, Turkey
| | - Ebru Tas
- Department of Gastroenterology, Dumlupinar University Faculty of Medicine, Evliya Celebi Research and Training Hospital, Kutahya, Turkey
| | - Aysel Caglar
- Department of Pathology, Ministry of Health Bagcilar State Hospital, Istanbul, Turkey
| | - Umit Seza Tetikkurt
- Department of Pathology, Ministry of Health Bagcilar State Hospital, Istanbul, Turkey
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Kłujszo E, Parcheta P, Zarębska-Michaluk D, Ochwanowska E, Witkowska A, Rakowska A, Rudnicka L, Kryczka W. Dermatologic adverse events of protease inhibitor-based combination therapy in patients with chronic hepatitis C. J Dermatol Case Rep 2014; 8:95-102. [PMID: 25621089 DOI: 10.3315/jdcr.2014.1183] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Accepted: 12/07/2014] [Indexed: 12/30/2022]
Abstract
BACKGROUND Combination therapy with pegylated interferon, ribavirin and a first-generation NS3/4A protease inhibitor, telaprevir or boceprevir, is the new strategy for treatment of genotype 1 chronic hepatitis C virus infection. This combination improves therapeutic efficacy but it also increases the risk of adverse events. OBJECTIVE The aim of the study was to analyze frequency and severity of dermatological adverse events during protease inhibitor-based therapy and to evaluate the risk factors for their development. PATIENTS AND METHODS This is a retrospective study of 109 patients with genotype 1 chronic hepatitis C treated with boceprevir (n=33) or telaprevir (n=76) based triple therapy. A logistic regression for relationship between clinical, demographic and laboratory factors and cutaneous adverse events was performed. RESULTS Dermatological adverse events (skin rash, pruritus, anorectal paresthesia) occurred in both treatments (boceprevir and telaprevir) with similar frequency: 28% in telaprevir and 21% in boceprevir. In patients treated with telaprevir, men were more predisposed to develop skin rashes compared to women (OR 4,1 p=0,014) and age above 45 years was associated with occurrence of pruritus in men (OR 8,16 p=0,014). Being a female, coexistence of autoimmune thyroiditis and advanced liver fibrosis were independent factors predisposing to development of anorectal paresthesia (OR 4,13 p=0,041, OR 4,25 p=0,029, OR 4,54 p=0,018 respectively) in this group. In patients treated with boceprevir, coexistence of autoimmune thyroiditis predisposed to skin rashes (OR 10,22 p=0,017) and being a female predisposed to pruritus (OR11,2 p=0,033). The adverse events occurred after a mean time of 8,6 (range 1-24) weeks after initiation of therapy. CONCLUSIONS In patients with chronic hepatitis C who received the triple therapy, the anorectal paresthesias were observed only in patients treated with telaprevir. The predisposing factors for this adverse event were: female gender and advanced liver fibrosis. The risk factors for other dermatological adverse were: 1) being a male over 45 years, for skin rashes and pruritus (for telaprevir), 2) coexistence of autoimmune thyroiditis for skin rashes (for boceprevir), 3) being a female, for pruritus (for boceprevir).
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Affiliation(s)
| | - Piotr Parcheta
- Department of Dermatology Provincial Hospital, Kielce, Poland
| | - Dorota Zarębska-Michaluk
- Department of Infections Disease Provincial Hospital, Kielce, Department of Health Science, Jan Kochanowski University, Kielce, Poland
| | - Ewa Ochwanowska
- Department of Animal Physiology, Jan Kochanowski University, Kielce, Poland
| | - Anna Witkowska
- Student of Medicine faculty, University of Szeged, Hungary
| | | | - Lidia Rudnicka
- Department of Dermatology, Medical University of Warsaw, Poland
| | - Wiesław Kryczka
- Department of Infections Disease Provincial Hospital, Kielce, Department of Health Science, Jan Kochanowski University, Kielce, Poland
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14
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Predictive factors for adverse dermatological events during pegylated/interferon alpha and ribavirin treatment for hepatitis C. J Clin Virol 2014; 60:190-5. [PMID: 24830933 DOI: 10.1016/j.jcv.2014.04.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 04/10/2014] [Accepted: 04/14/2014] [Indexed: 12/23/2022]
Abstract
BACKGROUND Treatment of chronic hepatitis C (CHC) with pegylated interferon-alpha/ribavirin is associated with well-characterized dermatological adverse events (AEs), which can lead to premature discontinuation of treatment. OBJECTIVE To investigate the incidence and spectrum of dermatological AEs during CHC treatment with interferon-alpha plus ribavirin and analyzed factors predisposing patients to such reactions. STUDY DESIGN Between January 2008 and December 2012, 152 CHC patients who had received interferon/pegylated interferon plus ribavirin therapy were enrolled in this retrospective study. To determine which factors were associated with dermatological AE development, a Cox proportional-hazards regression analysis was performed. RESULTS Thirty dermatological AEs were recorded in 28 (18.4%) patients. These reactions included 14 (9.2%) patients with eczematous reactions, four (2.6%) patients with xerosis, three (2.0%) patients with new-onset or exacerbation of psoriasis, two (1.3%) patients with lichenoid eruption, two (1.3%) patients with diffuse folliculitis and one patient with lichen planus, alopecia areata, hypermelanosis, and necrosis of the skin and toenails. Application of the Cox proportional-hazards model revealed that age older than 60 years (HR=1.070; 95% CI: 1.043-1.096), pre-existing anaphylaxis/skin disease (HR=2.612; 95% CI: 1.593-3.324), cirrhosis (HR=1.863; 95% CI: 1.047-3.013), and treatment with pegylated interferon formulations (HR=1.930; 95% CI: 1.052-3.687) were associated with occurrence of dermatologic AEs. Twenty-seven (90%) skin conditions were classified as mild to moderate, while one case (3.3%) warranted premature discontinuation of treatment. CONCLUSION Dermatological AEs resulting from interferon-alpha/ribavirin treatment of CHC contribute to a wide spectrum involve the skin, mucous membrane, hair, and nails. These dermatological AEs correlated with older age, previous skin condition, cirrhosis, and use of pegylated interferon formulations.
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15
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Federico A, Sgambato D, Cotticelli G, Gravina AG, Dallio M, Beneduce F, Ruocco E, Romano M, Loguercio C. Skin Adverse Events During Dual and Triple Therapy for HCV-Related Cirrhosis. HEPATITIS MONTHLY 2014; 14:e16632. [PMID: 24734094 PMCID: PMC3984470 DOI: 10.5812/hepatmon.16632] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Revised: 12/19/2013] [Accepted: 12/30/2013] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Dermatological adverse events are an existing concern during treatment of hepatitis C virus infection. Peginterferon/ribavirin treatment is associated with well-characterized dermatological lesions tending towards a uniform entity of dermatitis. New telaprevir- or boceprevir-based triple-therapy has led to significant improvements in sustained virological response rates, although associated with an increase in cutaneous adverse events compared peginterferon/ribavirin alone. CASE PRESENTATION We report a case of a patient who discontinued telaprevir because of severe skin eruptions and who, during ribavirin and interferon treatment, after a period free of skin lesions, developed new dermatological lesions different than those experienced during telaprevir treatment. CONCLUSIONS Several adverse effects are associated to anti-HCV drugs, hence appropriate skin care management and follow-up are very important. A careful anamnesis before the initiation of triple therapy is necessary to identify previous dermatological diseases that could increase skin adverse effects incidence.
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Affiliation(s)
- Alessandro Federico
- Department of Clinical and Experimental Medicine, Gastroenterology Unit, Second University of Naples, Naples, Italy
- Corresponding Author: Alessandro Federico, Department of Clinical and Experimental Medicine, Gastroenterology Unit, Second University of Naples, Naples, Italy. Tel: +39-815666723, Fax: +39-815666714, E-mail:
| | - Dolores Sgambato
- Department of Clinical and Experimental Medicine, Gastroenterology Unit, Second University of Naples, Naples, Italy
| | - Gaetano Cotticelli
- Department of Clinical and Experimental Medicine, Gastroenterology Unit, Second University of Naples, Naples, Italy
| | - Antonietta Gerarda Gravina
- Department of Clinical and Experimental Medicine, Gastroenterology Unit, Second University of Naples, Naples, Italy
| | - Marcello Dallio
- Department of Clinical and Experimental Medicine, Gastroenterology Unit, Second University of Naples, Naples, Italy
| | - Filippo Beneduce
- Department of Clinical and Experimental Medicine, Gastroenterology Unit, Second University of Naples, Naples, Italy
| | - Eleonora Ruocco
- Department of Dermatology, Second University of Naples, Naples, Italy
| | - Marco Romano
- Department of Clinical and Experimental Medicine, Gastroenterology Unit, Second University of Naples, Naples, Italy
| | - Carmela Loguercio
- Department of Clinical and Experimental Medicine, Gastroenterology Unit, Second University of Naples, Naples, Italy
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Alopecia universalis after discontinuation of pegylated interferon and ribavirin combination therapy for hepatitis C: a case report. Ann Hepatol 2014. [DOI: 10.1016/s1665-2681(19)30894-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
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Gönül M, Çakmak SK, Özcan N, Oǧuz ID, Özhamam E. Erythema Annulare Centrifugum due to Pegylated Interferon-α-2a plus Ribavirin Combination Therapy in a Patient with Chronic Hepatitis C Virus Infection. J Cutan Med Surg 2014; 18:65-8. [DOI: 10.2310/7750.2013.13051] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background: Pegylated interferon-α combined with ribavirin is the current standard treatment for chronic hepatitis C virus infection. During interferon and ribavirin therapy, both local and generalized mucocutaneous adverse reactions have been reported. Erythema annulare centrifugum induced by this therapy regimen has not been reported previously. Case Report: A 29-year-old woman was referred to our clinic for a 1-week history of slightly pruritic annular erythematous eruptions on the lower extremities and hands. The eruptions had first occured on the hands 3 to 4 days after pegylated interferon-α-2a plus ribavirin combination therapy for hepatitis C virus infection. Histopathologic examination supported the diagnosis of erythema annulare centrifugum. The lesions completely regressed within 2 weeks after the cessation of treatment but recurred on similar localizations within 24 hours with the same therapy. It was thought that erythema annulare centrifugum was induced by pegylated interferon-α-2a plus ribavirin combination therapy. Conclusion: Erythema annulare centrifugum is considered an inflammatory skin disease with unknown etiology. It is thought to represent a hypersensitivity reaction to some triggering factors, including infections, immunologic disorders, malign neoplasms, foods, pregnancy, and drugs. We report the first case of erythema annulare centrifigum induced by pegylated interferon-α-2a plus ribavirin combination therapy.
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Affiliation(s)
- Müzeyyen Gönül
- From the Dermatology and Pathology Clinics, Ankara Numune Education and Research Hospital, Sihhiye, Ankara, Turkey
| | - Seray Külcü Çakmak
- From the Dermatology and Pathology Clinics, Ankara Numune Education and Research Hospital, Sihhiye, Ankara, Turkey
| | - Nimet Özcan
- From the Dermatology and Pathology Clinics, Ankara Numune Education and Research Hospital, Sihhiye, Ankara, Turkey
| | - Işil Deniz Oǧuz
- From the Dermatology and Pathology Clinics, Ankara Numune Education and Research Hospital, Sihhiye, Ankara, Turkey
| | - Esra Özhamam
- From the Dermatology and Pathology Clinics, Ankara Numune Education and Research Hospital, Sihhiye, Ankara, Turkey
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Dag MS, Oztürk ZA, Yılmaz N, Cam H, Kadayıfçı A. Peginterferon alfa related psoriasis in a patient with acute hepatitis C and review of the literature. Wien Klin Wochenschr 2013; 125:537-40. [PMID: 23912615 DOI: 10.1007/s00508-013-0408-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 07/16/2013] [Indexed: 01/27/2023]
Abstract
The Interferon (IFN) which is the standard treatment for Hepatitis C, may cause a lot of side effects including dermatological anomalies. This paper presents a psoriasis case which occurred in relation with the treatment of acute hepatitis C (AHC) with peginterferon alfa (peg-IFN-α). A 60-year-old male patient came to the hospital with symptoms of high liver enzymes. The patient with history of a recent operation showed anti-HCV(+), HCVRNA 3.5 million IU/mL and HCV genotype 1b in the tests. Without any other etiological factors found in the patient, we started a treatment of peg-IFNα-2b with the diagnosis of AHC. After 3 weeks, psoriatic plaques were observed in various parts of the body. Antiviral treatment of the patient was concluded within 6 months. His psoriasis treatment initially commenced with local agents followed by phototherapy. Permanent viral response was seen in the patient and his lesions recovered rapidly after the antipsoriatic and antiviral treatment. Psoriasis and other autoimmune diseases should be considered even though they are encountered rarely,and the patients should be informed of the possible risks before planning treatment with peg-IFN-α.
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Affiliation(s)
- Muhammed Sait Dag
- Faculty of Medicine, Department of Internal Medicine, Division of Gastroenterology, Gaziantep University, 27100, Sahinbey, Gaziantep, Turkey
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Naccarato M, Yoong D, Solomon R, Ostrowski M. Erythema annulare centrifugum-like eruption associated with pegylated interferon treatment for hepatitis C. Dermatol Reports 2013; 5:e1. [PMID: 25386320 PMCID: PMC4209710 DOI: 10.4081/dr.2013.e1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Revised: 07/05/2013] [Accepted: 07/08/2013] [Indexed: 01/22/2023] Open
Abstract
Current standard of treatment for chronic hepatitis C virus infection requires the use of pegylated interferon plus ribavirin. Treatment with these two agents has been associated with numerous side effects, which frequently include dermatologic eruptions. We report a cutaneous eruption associated with interferon having clinical presentation of erythema annulare centrifugum. The eruption occurred within days of the first interferon injection and repeatedly flared following subsequent injections. Our patient was able to continue therapy without interruption, while managing the reaction with topical corticosteroid and oral antihistamine. We conclude that this is a benign cutaneous eruption associated with interferon which can be managed without discontinuing treatment for hepatitis C.
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Affiliation(s)
- Mark Naccarato
- Department of Infectious Diseases and HIV, St. Michael's Hospital , Toronto, Ontario
| | - Deborah Yoong
- Department of Infectious Diseases and HIV, St. Michael's Hospital , Toronto, Ontario
| | - Robert Solomon
- Department of Dermatology, St. Michael's Hospital , Toronto, Ontario
| | - Mario Ostrowski
- Department of Infectious Diseases and HIV, St. Michael's Hospital , Toronto, Ontario ; Faculty of Medicine, University of Toronto, 1 King's College Circle , Toronto, Ontario, Canada
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Torii H, Sueki H, Kumada H, Sakurai Y, Aoki K, Yamada I, Ohtsuki M. Dermatological side-effects of telaprevir-based triple therapy for chronic hepatitis C in phase III trials in Japan. J Dermatol 2013; 40:587-95. [PMID: 23734933 DOI: 10.1111/1346-8138.12199] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2012] [Accepted: 04/08/2013] [Indexed: 12/12/2022]
Abstract
Telaprevir-based triple therapy is highly effective for chronic hepatitis C. However, concern has been expressed over the high frequency and severity of its dermatological side-effects compared with those associated with peginterferon (PEG-IFN) and ribavirin (RBV) therapy. Thus, here, we evaluated the dermatological adverse reactions of telaprevir-based triple therapy in Japanese multicenter phase III clinical trials in an attempt to characterize the dermatological side-effects and establish appropriate management plans. In these trials, 126 treatment-naïve patients and 141 treatment-failure patients were administrated telaprevir, PEG-IFN-α-2b and RBV for 12 weeks followed by PEG-IFN-α-2b and RBV for another 12 weeks (T12/PR24 group), and 63 treatment-naïve patients were administrated PEG-IFN-α-2b and RBV for 48 weeks (PR48 group). Dermatological adverse reactions developed in over 80% patients in both groups, and most of them were grade 1 or 2. In the T12/PR24 group, there were more grade 2 or grade 3 events, and the time to onset was earlier than that in the PR48 group. Most reactions could be managed with topical corticosteroids and oral antihistamines, and the rates of discontinuation due to dermatological reactions were not high even in the T12/PR24 group. In the T12/PR24 group, however, two cases of Stevens-Johnson syndrome and one case of drug rash with eosinophilia and systemic symptoms, which corresponds to drug-induced hypersensitivity syndrome in Japan, were reported. For appropriate treatments of individual dermatological adverse reactions, the judgment of discontinuation of antiviral drugs and treatment based on the severity are extremely important in this triple therapy.
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Affiliation(s)
- Hideshi Torii
- Division of Dermatology, Social Insurance Central General Hospital, Tokyo, Japan.
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Ortiz-Riaño E, Cheng BYH, Carlos de la Torre J, Martínez-Sobrido L. Arenavirus reverse genetics for vaccine development. J Gen Virol 2013; 94:1175-1188. [PMID: 23364194 DOI: 10.1099/vir.0.051102-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Arenaviruses are important human pathogens with no Food and Drug Administration (FDA)-licensed vaccines available and current antiviral therapy being limited to an off-label use of the nucleoside analogue ribavirin of limited prophylactic efficacy. The development of reverse genetics systems represented a major breakthrough in arenavirus research. However, rescue of recombinant arenaviruses using current reverse genetics systems has been restricted to rodent cells. In this study, we describe the rescue of recombinant arenaviruses from human 293T cells and Vero cells, an FDA-approved line for vaccine development. We also describe the generation of novel vectors that mediate synthesis of both negative-sense genome RNA and positive-sense mRNA species of lymphocytic choriomeningitis virus (LCMV) directed by the human RNA polymerases I and II, respectively, within the same plasmid. This approach reduces by half the number of vectors required for arenavirus rescue, which could facilitate virus rescue in cell lines approved for human vaccine production but that cannot be transfected at high efficiencies. We have shown the feasibility of this approach by rescuing both the Old World prototypic arenavirus LCMV and the live-attenuated vaccine Candid#1 strain of the New World arenavirus Junín. Moreover, we show the feasibility of using these novel strategies for efficient rescue of recombinant tri-segmented both LCMV and Candid#1.
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Affiliation(s)
- Emilio Ortiz-Riaño
- Department of Microbiology and Immunology, University of Rochester, 601 Elmwood Avenue, Rochester, NY 14642, USA
| | - Benson Yee Hin Cheng
- Department of Microbiology and Immunology, University of Rochester, 601 Elmwood Avenue, Rochester, NY 14642, USA
| | - Juan Carlos de la Torre
- Department of Immunology and Microbial Science, Scripps Research Institute, La Jolla, CA 92037, USA
| | - Luis Martínez-Sobrido
- Department of Microbiology and Immunology, University of Rochester, 601 Elmwood Avenue, Rochester, NY 14642, USA
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22
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López Peláez MV, González Díaz P, Téllez Molina MJ, Vergas García J. [Lingual hyperpigmentation in a patient with chronic infection]. Enferm Infecc Microbiol Clin 2012; 31:264-5. [PMID: 23260387 DOI: 10.1016/j.eimc.2012.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Revised: 09/12/2012] [Accepted: 10/23/2012] [Indexed: 11/26/2022]
Affiliation(s)
- María Vanessa López Peláez
- Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna III, Hospital Clínico San Carlos, Madrid, Spain.
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23
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Omazzi B, Prada A, Borroni G, Sacrini F. Irreversible alopecia universalis during treatment with pegylated interferon-ribavirin for chronic hepatitis C virus infection: Case report and published work review. Hepatol Res 2012. [PMID: 23181541 DOI: 10.1111/j.1872-034x.2012.01036.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Hair disorders that have been described in association with pegylated interferon-ribavirin combination treatment include canities, hypertrichosis, telogen effluvium, and the most common cutaneous side-effect by far, alopecia. Alopecia is a heterogeneous disease characterized by hair loss on the scalp or any hair-bearing surface with a wide range of clinical presentations, from a single patch of hair loss to complete loss of hair on the entire body (alopecia universalis). Although some cases of reversible alopecia universalis associated with pegylated interferon-ribavirin combination therapy have been reported in the published work, irreversible alopecia universalis has not yet been reported in relation to pegylated interferon and ribavirin combination treatment. For the first time, we report a case of irreversible alopecia universalis during pegylated interferon-ribavirin combination therapy in a man infected with hepatitis C virus in the absence of clinical or biochemical evidence of immunological disorders or thyroid dysfunction at any time before, during or after antiviral therapy.
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Affiliation(s)
- Barbara Omazzi
- Division of Gastroenterology, G. Salvini Hospital, Rho, Alcohol Addiction Unit, ASL Provincia di Milano 1, Abbiategrasso, Division of Dermatology, IRCCS Istituto Clinico Humanitas, Rozzano, Italy
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24
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Sherman KE. Therapeutic approach to the treatment-naive patient with hepatitis C virus genotype 1 infection: a step-by-step approach. Clin Infect Dis 2012; 55:1236-41. [PMID: 22843782 PMCID: PMC3529612 DOI: 10.1093/cid/cis628] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2012] [Accepted: 07/09/2012] [Indexed: 12/15/2022] Open
Abstract
Recent advances in the treatment of hepatitis C virus infection (HCV) have led to high rates of viral cure. However, the use of newly approved protease inhibitors with activity against HCV still requires careful patient selection, counseling, and decision making before initiation of treatment. Laboratory work-up, staging of liver disease, and careful review of comorbid conditions is mandatory. Patients with cirrhosis may require treatment regimens that differ from those without cirrhosis. Because pegylated interferon alfa and ribavirin remain a key part of the treatment regimen, absolute and relative contraindications to their use must be considered. Management of common adverse events including anemia and rash must be embraced by the healthcare provider.
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Affiliation(s)
- Kenneth E Sherman
- University of Cincinnati College of Medicine/UC Health, Division of Digestive Diseases, 231 Albert Sabin Way, Cincinnati, OH 45267-0595, USA.
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25
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Picard O, Cacoub P. Dermatological adverse effects during genotype-1 hepatitis C treatment with the protease inhibitors telaprevir and boceprevir. Patient management. Clin Res Hepatol Gastroenterol 2012; 36:437-40. [PMID: 22483956 DOI: 10.1016/j.clinre.2012.02.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Accepted: 02/25/2012] [Indexed: 02/04/2023]
Affiliation(s)
- Odile Picard
- Department of infectious and communicable diseases, Hôpital Saint-Antoine, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France.
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26
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27
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Labro MT. Immunomodulatory effects of antimicrobial agents. Part I: antibacterial and antiviral agents. Expert Rev Anti Infect Ther 2012; 10:319-40. [PMID: 22397566 DOI: 10.1586/eri.12.11] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Despite impressive therapeutic progresses in the battle against infections, microorganisms are still a threat to mankind. With hundreds of antibacterial molecules, major concerns remain about the emergence of resistant and multidrug-resistant pathogens. On the other hand, the antiviral drug armamentarium is comprised of only a few dozens of compounds which are highly pathogen specific, and resistance is also a concern. According to Arturo Casadevall (Albert Einstein College of Medicine, NY, USA), we have now entered the third era of anti-infective strategy, which intends to favor the interplay between active molecules and the immune system. The first part of this review focuses on the potential immunomodulating properties of anti-infective agents, beginning with antibacterial and antiviral agents.
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Affiliation(s)
- Marie-Thérèse Labro
- Inserm SC14 Centre d'Expertise Collective, Université Paris Diderot Paris, 7 Faculté de Médecine Site Bichat, 16 rue Henri Huchard, 75890, Paris Cedex 18, France.
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28
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Severe deterioration of newly diagnosed Takayasu arteritis in a patient re-treated with interferon beta-1α for concomitant longstanding multiple sclerosis. Mod Rheumatol 2012; 22:474-8. [DOI: 10.1007/s10165-011-0529-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Accepted: 08/25/2011] [Indexed: 11/25/2022]
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29
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NASPGHAN practice guidelines: Diagnosis and management of hepatitis C infection in infants, children, and adolescents. J Pediatr Gastroenterol Nutr 2012; 54:838-55. [PMID: 22487950 DOI: 10.1097/mpg.0b013e318258328d] [Citation(s) in RCA: 138] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Hepatitis C virus (HCV) is an RNA virus that affects >180 million individuals worldwide with a high propensity for chronic infection. Children with HCV infection differ from adults in several ways including some modes of transmission, rates of clearance, progression of fibrosis, and the duration of potential chronic infection when acquired at birth. Since the discovery of HCV in 1989, there have been significant advances in the understanding of the virology and natural history of chronic HCV infection in children. In addition, there are now several treatment options for children with chronic hepatitis C infection and many new therapies on the horizon. As a consequence, the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition brought together experts in pediatric hepatology to review the available data in children and provide clinicians with approaches to the diagnosis, management, and prevention of HCV infection in children and adolescents. The guideline details the epidemiology and natural history of HCV infection in children, the diagnostic workup, monitoring and treatment of disease, and provides an update on future treatment options and areas of research.
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Abstract
Arenaviruses include several causative agents of hemorrhagic fever (HF) disease in humans that are associated with high morbidity and significant mortality. Morbidity and lethality associated with HF arenaviruses are believed to involve the dysregulation of the host innate immune and inflammatory responses that leads to impaired development of protective and efficient immunity. The molecular mechanisms underlying this dysregulation are not completely understood, but it is suggested that viral infection leads to disruption of early host defenses and contributes to arenavirus pathogenesis in humans. We demonstrate in the accompanying paper that the prototype member in the family, lymphocytic choriomeningitis virus (LCMV), disables the host innate defense by interfering with type I interferon (IFN-I) production through inhibition of the interferon regulatory factor 3 (IRF3) activation pathway and that the viral nucleoprotein (NP) alone is responsible for this inhibitory effect (C. Pythoud, W. W. Rodrigo, G. Pasqual, S. Rothenberger, L. Martínez-Sobrido, J. C. de la Torre, and S. Kunz, J. Virol. 86:7728-7738, 2012). In this report, we show that LCMV-NP, as well as NPs encoded by representative members of both Old World (OW) and New World (NW) arenaviruses, also inhibits the nuclear translocation and transcriptional activity of the nuclear factor kappa B (NF-κB). Similar to the situation previously reported for IRF3, Tacaribe virus NP (TCRV-NP) does not inhibit NF-κB nuclear translocation and transcriptional activity to levels comparable to those seen with other members in the family. Altogether, our findings demonstrate that arenavirus infection inhibits NF-κB-dependent innate immune and inflammatory responses, possibly playing a key role in the pathogenesis and virulence of arenavirus.
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Crespo G, Lens S. Uso de boceprevir y telaprevir en pacientes con VHC (aspectos prácticos). GASTROENTEROLOGIA Y HEPATOLOGIA 2012; 35:337-43. [DOI: 10.1016/j.gastrohep.2011.12.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Accepted: 12/23/2011] [Indexed: 10/28/2022]
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Habte-Gabr E, Lecea N. Psoriasis and hepatitis C: improvement with interferon. Ann Dermatol 2012; 23:S411-3. [PMID: 22346292 PMCID: PMC3276811 DOI: 10.5021/ad.2011.23.s3.s411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Revised: 06/27/2011] [Accepted: 08/08/2011] [Indexed: 11/08/2022] Open
Affiliation(s)
- Eyassu Habte-Gabr
- Director of Infectious Diseases at Hurley Medical Center, Flint, Michigan, and is a Professor at Michigan State University, East Lansing, Michigan, USA
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López-Pestaña A, Tuneu A, Lobo C, Zubizarreta J. [Sarcoid granulomas in facial cosmetic filler material: induction by interferon-α and ribavirin in a patient with hepatitis C]. ACTAS DERMO-SIFILIOGRAFICAS 2012; 102:746-7. [PMID: 21640959 DOI: 10.1016/j.ad.2011.01.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2010] [Revised: 01/17/2011] [Accepted: 01/23/2011] [Indexed: 11/28/2022] Open
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Dermatological side effects of hepatitis C and its treatment: patient management in the era of direct-acting antivirals. J Hepatol 2012; 56:455-63. [PMID: 21884670 DOI: 10.1016/j.jhep.2011.08.006] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2011] [Revised: 07/26/2011] [Accepted: 08/02/2011] [Indexed: 12/15/2022]
Abstract
Dermatological adverse events (AEs) are an existing concern during hepatitis C virus (HCV) infection and peginterferon/ribavirin treatment. HCV infection leads to dermatological and muco-cutaneous manifestations including small-vessel vasculitis as part of the mixed cryoglobulinemic syndrome. Peginterferon/ribavirin treatment is associated with well-characterized dermatological AEs tending towards a uniform entity of dermatitis. New direct-acting antivirals have led to significant improvements in sustained virologic response rates, but several have led to an increase in dermatological AEs versus peginterferon/ribavirin alone. In telaprevir trials, approximately half of treated patients had rash. More than 90% of these events were Grade 1 or 2 (mild/moderate) and in the majority (92%) of cases, progression to a more severe grade did not occur. In a small number of cases (6%), rash led to telaprevir discontinuation, whereupon symptoms commonly resolved. Dermatological AEs with telaprevir-based triple therapy were generally similar to those observed with peginterferon/ribavirin (xerosis, pruritus, and eczema). A few cases were classified as severe cutaneous adverse reaction (SCAR), also referred to as serious skin reactions, a group of rare conditions that are potentially life-threatening. It is therefore important to distinguish between telaprevir-related dermatitis and SCAR. The telaprevir prescribing information does not require telaprevir discontinuation for Grade 1 or 2 (mild/moderate) rash, which can be treated using emollients/moisturizers and topical corticosteroids. For Grade 3 rash, the prescribing information mandates immediate telaprevir discontinuation, with ribavirin interruption (with or without peginterferon) within 7 days of stopping telaprevir if there is no improvement, or sooner if it worsens. In case of suspicion or confirmed diagnosis of SCAR, all study medication must be discontinued.
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Pulpitis seca y fisuras en los dedos de las manos en pacientes que reciben tratamiento combinado para hepatitis C. Rev Clin Esp 2012; 212:115-7. [DOI: 10.1016/j.rce.2011.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2011] [Accepted: 05/29/2011] [Indexed: 11/22/2022]
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Sarcoid Granulomas in Facial Cosmetic Filler Material: Induction by Interferon-α and Ribavirin in a Patient with Hepatitis C. ACTAS DERMO-SIFILIOGRAFICAS 2011. [DOI: 10.1016/j.adengl.2011.11.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Castellanos González M, Pérez Carreras M, Muñoz Gómez R, Castellano Tortajada G. [Cutaneous necrosis due to injection of interferon-alpha 2b in a patient with chronic hepatitis C]. GASTROENTEROLOGIA Y HEPATOLOGIA 2011; 34:584-5. [PMID: 21641684 DOI: 10.1016/j.gastrohep.2011.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Accepted: 03/01/2011] [Indexed: 11/17/2022]
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Current awareness: Pharmacoepidemiology and drug safety. Pharmacoepidemiol Drug Saf 2010. [DOI: 10.1002/pds.1850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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