Case Report

Correlation of Liver and Skin Histopathology With Serology in a Patient With Cutaneous Vasculitis and Hepatitis C Infection

Authors: MATTHEW H. ORNSTEIN MD, ROBERT PHELPS MD, LESLIE DUBIN KERR MD, HARRY SPIERA MD

Abstract

ABSTRACT: A strong body of evidence supports a viral etiology for many forms of vasculitis. Recent literature supports the association of the hepatitis C virus (HCV) with essential mixed cryoglobulinemia. We describe a case of cutaneous vasculitis associated with simultaneous active hepatic inflammation demonstrated by skin and liver biopsies. Immunofluorescence, hepatitis C serology, and study of the cryoprecipitate all confirmed HCV infection and deposition of immune complexes. Treatment with interferon alpha-2b was extremely effective as compared with prednisone and colchicine. This case provides further evidence that active hepatic infection with HCV may be a cause of cryoglobulinemia and cutaneous vasculitis. It also suggests that further studies of antiviral therapy for vasculitis should be explored.

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References