Photo-accentuated eruption and vascular deposits of immunoglobulin A associated with hepatitis A virus infection.
Skin rash associated with hepatitis A virus infection has rarely been reported. We describe a patient with hepatitis A virus infection who presented a rubelliform rash markedly accentuated in sun-exposed areas; direct immunofluorescence studies of the lesion revealed immunoglobulin (Ig) A deposition on the endothelial cells in the upper dermis. Oral rechallenge tests of the previously administered drugs failed to reproduce the eruption. The preferential setting of immune complexes containing IgA at sites of sun exposure and sunlight as a triggering factor might have been responsible for the development of the eruption in this patient. Eruptions associated with hepatitis A virus infections may be more frequent than commonly thought. Because of difficulty to exclude the possibility of drug eruptions, these cases might have been overlooked. In patients with such a disorder, a careful clinical workup such as IgM antibodies for hepatitis A virus at diagnosis and during follow-up is especially recommended.
Kano
Y
Y
Department of Dermatology, Kyorin University School of Medicine, Tokyo, Japan.
Kokaji
T
T
Shiohara
T
T
D000328:Adult; D000914:Antibodies, Viral / Q000032:analysis; D004730:Endothelium, Vascular / Q000276:immunology*; D006506:Hepatitis A / Q000150:complications* / Q000821:virology; D006507:Hepatovirus / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000378:metabolism*; D008297:Male; D010787:Photosensitivity Disorders / Q000150:complications / Q000473:pathology*; D012867:Skin / Q000276:immunology / Q000473:pathology
D000914:Antibodies, Viral; D007070:Immunoglobulin A