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a woman has long, twisting arms, covered in a skin disorder, as one hand holds a liver and the other hand holds a DNA double helix

The Association between Hepatitis C and Chronic Inflammatory Skin Disease

Jess Mangiaracina PA - C's avatar image

By Jess Mangiaracina PA - C

2 min read

Hepatitis C is known to cause extrahepatic manifestations. One organ hep C can affect is the skin. A recent article based out of Taiwan investigates the association between hepatitis C and chronic inflammatory skin disease. The chronic skin diseases included in the study were psoriasis, lichen planus, vitiligo, alopecia areata, pemphigus, bullous pemphigoid, hidradenitis suppurativa, cutaneous lupus, sclerosis, dermatomyositis, morphea, and pyoderma gangrenosum.1

How hepatitis C can lead to skin problems

A total of 23,509 hepatitis C patients and 94,036 patients without hepatitis C were included in the study from January 1, 1998 to December 31, 2011. It was found that hepatitis C patients had a 6.34 fold increased risk for chronic inflammatory skin disease compared to the control group. Hepatitis C patients were more likely to develop lichen planus, psoriasis, vitiligo, alopecia areata, and lupus. The risk of psoriasis was decreased after interferon-based treatment (which was previously used to treat hepatitis C).1

Risks vary by country

The risk of these chronic inflammatory skin diseases are related to genetics and race. The risk of psoriasis was seen in this study, in the Taiwanese patients, however the authors point out that two database studies in the United States showed no significant increased risk of psoriasis in those with hepatitis C. The risk of lichen planus also varies based on geographic location, with the highest prevalence in East Asia at 8.9%. In other studies, vitiligo, alopecia areata, and cutaneous lupus erythematosus are less commonly linked to hepatitis C. There may be an association with alopecia areata in patients after receiving interferon-based treatments.1

The relationship between lupus and hepatitis C is unclear, with studies showing an increased prevalence, lupus appearing after interferon therapy, and lupus clearing after interferon therapy.1

Interferon treatments and the skin

Interferon-based therapy has been shown to both exacerbate and decrease flares of chronic inflammatory skin diseases in recent studies. In a few studies, interferon-based therapy has been shown to exacerbate lichen planus, psoriasis, vitiligo, alopecia areata, and lupus. In this study in Taiwan, interferon-based therapy was found to decrease flares of chronic inflammatory skin diseases, especially psoriasis. More studies are needed to determine the effects of interferon-based treatments on the development of chronic inflammatory skin diseases.1

Although this study was limited due to patient geography and unreported lifestyle habits such as smoking and alcohol intake, the article shows that there is a link between hepatitis C and chronic inflammatory skin diseases. Monitoring hepatitis C patients for these skin diseases is recommended.1

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