title: Secondary hyperpigmentation during interferon alfa treatment for chronic hepatitis C virus infection.
abstract: OBJECTIVE
  Interferon alfa remains the central treatment for chronic hepatitis C virus (HCV) infection. Cases of cutaneous and mucous hyperpigmentations during interferon alfa treatment have been reported, but they are considered rare adverse effects.
  
  
  OBJECTIVE
  To study the clinical presentation and frequency of hyperpigmentation in patients receiving interferon alfa treatment for chronic HCV infection.
  
  
  METHODS
  Prospective, descriptive clinical trial.
  
  
  METHODS
  Monocentric study performed in the Departments of Hepatology and Dermatology of the University Hospital of Nice, Nice, France.
  
  
  METHODS
  Consecutive patients treated with pegylated interferon alfa-2b and ribavirin for chronic HCV infection.
  
  
  METHODS
  Demographic data and medical history were noted. A systematic clinical and dermoscopic examination of skin, nails, and mucous membranes was performed, and skin biopsies were performed if needed.
  
  
  RESULTS
  Of 77 patients who were included, 16 (21%) presented with hyperpigmentation. Hyperpigmentation of the oral mucous membrane, acquired longitudinal melononychia, and hyperpigmentation of the face were each observed in 7 patients (9%). All patients with hyperpigmentation of the skin had skin type III or IV and worked outside without sun protection. The intensity of pigmentation was reported to decrease progressively when interferon treatment was discontinued. Most patients with hyperpigmentation of the oral mucosa also had melanonychia. However, patients with hyperpigmentation of the skin did not have mucosal or nail involvement, suggesting 2 distinct mechanisms.
  
  
  CONCLUSIONS
  Secondary hyperpigmentation during interferon alfa treatment occurs as an adverse event in 21% of patients, especially in those with dark skin types who have unprotected sun exposure. Physicians should be aware of the adverse effects of interferon treatment and advise patients in the use of sun protection, especially patients with darker skin types.
authors.affiliation: Department of Dermatology, INSERM U1065 Team 12, University Hospital of Nice, Nice, France.
authors.forename: Katerina
authors.initials: K
authors.lastname: Tsilika
authors.forename: Albert
authors.initials: A
authors.lastname: Tran
authors.forename: Régine
authors.initials: R
authors.lastname: Trucchi
authors.forename: Sinziana
authors.initials: S
authors.lastname: Pop
authors.forename: Rodolphe
authors.initials: R
authors.lastname: Anty
authors.forename: Nathalie
authors.initials: N
authors.lastname: Cardot-Leccia
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Lacour
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Ortonne
authors.forename: Thierry
authors.initials: T
authors.lastname: Passeron
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D017495:Hyperpigmentation / Q000139:chemically induced*; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D011092:Polyethylene Glycols / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D012254:Ribavirin / Q000008:administration & dosage / Q000627:therapeutic use*; D012880:Skin Pigmentation / Q000187:drug effects
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b