title: Alopecia universalis after discontinuation of pegylated interferon and ribavirin combination therapy for hepatitis C: a case report.
abstract: For the last decade, the combination therapy of pegylated interferon (Peg-IFN) plus ribavirin (RBV) has been considered as the standard of care treatment for chronic hepatitis C virus (HCV) infection. However, it has been associated with an increased incidence of many adverse cutaneous reactions and emergence of autoantibodies or even autoimmune diseases. We report a case of irreversible alopecia universalis (AU) with complete hair loss extended to the whole body, which started after discontinuation of Peg-IFN/RBV combination therapy for chronic HCV infection. In conclusion, this case represents an uncommon presentation of a common disease. Physicians must be aware of the potential adverse reactions of an antiviral therapy containing IFN, which might occur even after the discontinuation, and fully inform the patient at the beginning of his treatment course. We hope that interferon-free regimens will utterly supplant interferon-based therapy for most or all HCV patients avoiding the emergence of autoimmune manifestations.
authors.affiliation: Dipartimento di Scienze Mediche e Chirurgiche dell'Invecchiamento e Malattie Nefrologiche, Università di Bologna and Azienda Ospedaliero Universitaria, Policlinico Sant'Orsola Malpighi di Bologna, Italy.
authors.forename: Nesrine
authors.initials: N
authors.lastname: Gamal
authors.affiliation: Dipartimento di Scienze Mediche e Chirurgiche dell'Invecchiamento e Malattie Nefrologiche, Università di Bologna and Azienda Ospedaliero Universitaria, Policlinico Sant'Orsola Malpighi di Bologna, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Brodosi
authors.affiliation: Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale and Azienda Ospedaliero Universitaria, Policlinico Sant'Orsola Malpighi di Bologna, Italy.
authors.forename: Cosimo
authors.initials: C
authors.lastname: Misciali
authors.affiliation: Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale and Azienda Ospedaliero Universitaria, Policlinico Sant'Orsola Malpighi di Bologna, Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Patrizi
authors.affiliation: Dipartimento di Medicina Interna, dell'Invecchiamento e Malattie Nefrologiche, Università di Bologna and Azienda Ospedaliero Universitaria, Policlinico Sant'Orsola Malpighi di Bologna, Italy.
authors.forename: Gentiana
authors.initials: G
authors.lastname: Vukatana
authors.affiliation: Dipartimento di Medicina Interna, dell'Invecchiamento e Malattie Nefrologiche, Università di Bologna and Azienda Ospedaliero Universitaria, Policlinico Sant'Orsola Malpighi di Bologna, Italy.
authors.forename: Nazzarena
authors.initials: N
authors.lastname: Malavolta
authors.affiliation: Dipartimento di Scienze Mediche e Chirurgiche dell'Invecchiamento e Malattie Nefrologiche, Università di Bologna and Azienda Ospedaliero Universitaria, Policlinico Sant'Orsola Malpighi di Bologna, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Bernardi
authors.affiliation: Dipartimento di Scienze Mediche e Chirurgiche dell'Invecchiamento e Malattie Nefrologiche, Università di Bologna and Azienda Ospedaliero Universitaria, Policlinico Sant'Orsola Malpighi di Bologna, Italy.
authors.forename: Pietro
authors.initials: P
authors.lastname: Andreone
mesh_terms: D000505:Alopecia / Q000175:diagnosis* / Q000209:etiology*; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use; D001706:Biopsy; D004359:Drug Therapy, Combination; D019698:Hepatitis C, Chronic / Q000188:drug therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011092:Polyethylene Glycols / Q000009:adverse effects* / Q000627:therapeutic use*; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D012254:Ribavirin / Q000627:therapeutic use*; D012535:Scalp / Q000473:pathology; D016896:Treatment Outcome; D028761:Withholding Treatment
chemical_list: D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b