Lichenoid drug eruption due to initiation of IFN alfa therapy for

hepatitis C virus infection

-case report-Andreea Stancu* , Aurel Doru Chirita**, Irina Margaritescu**

* „Carol Davila” University Emergency Central Military Hospital, Bucharest ** "Domina-Sana" Medical Center Bucharest.

Introduction• Interferon alpha is the treatment of choice for

chronic hepatitis C virus (HCV) infection• Cutaneous reactions to interferon therapy,

both local and distant from the injection site, are not uncommon

• Eczematous and lichenoid reactions are most commonly reported

• Cutaneous adverse reactions were more common in the combined IFN/ribavirin than in the IFN monotherapy in literature

Clinical caseWe report the case of a 62-year-old man undergoing treatment with interferon alpha therapy for hepatitis C, who developed a lichenoid drug eruption associated with interferon injections

Clinical case

Initial lesions located at the injection site

Clinical case

Typical well-circumscribed papules on the anterior aspects of forearm

A widespread subsequent eruption of pruritic papules on the trunk and abdomen

Superficial lichenoid dermatitis, perivascular and perianexial (infundibulofollicular)

basal vacuolar changes with obscuration of dermoepidermal jonction

necrotic keratinocytes scattered melanophages

occupied in the papillary dermis

Conclusions• Dermatologic side effects of IFN alpha have

included skin rash, injection site reaction, diaphoresis, partial alopecia, dry skin, pruritus, hematoma

• Interferon therapy has also been associated with the occurrence or worsening of a number of dermatologic disorders

• The skin reaction at the injection site is a strong argument that supports our diagnosis

• To our knowledge, this is one of a few reported cases of a lichenoid drug reaction triggered by interferon