title: Photo-distributed lichenoid eruption secondary to direct anti-viral therapy for hepatitis C.
abstract: Novel direct anti-viral agents are emerging as effective treatments for hepatitis C virus (HCV) and provide an alternative to the year-long standard therapy with interferon and ribavirin. However, cutaneous side effects from these new medications, including rash, pruritus and photosensitivity, are among the most commonly reported adverse events and have resulted in therapy discontinuation in some cases. Here, we report two cases of a photo-distributed lichenoid eruption that occurred within 1  month of starting anti-viral therapy with simeprevir and sofosbuvir without interferon or ribavirin. This report provides the first histologic description of the cutaneous eruption associated with direct anti-viral therapy for HCV and highlights the importance of recognizing and treating the often intolerable dermatologic side effects of these novel medications, the incidence of which is likely to increase as direct anti-viral agents may become the standard of care for HCV.
authors.affiliation: Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Cory L
authors.initials: CL
authors.lastname: Simpson
authors.affiliation: Drew McCausland, MD, Ltd., West Chester, PA, USA.
authors.forename: Drew
authors.initials: D
authors.lastname: McCausland
authors.affiliation: Department of Dermatology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA.
authors.forename: Emily Y
authors.initials: EY
authors.lastname: Chu
mesh_terms: D000998:Antiviral Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001706:Biopsy; D003875:Drug Eruptions / Q000209:etiology; D004359:Drug Therapy, Combination; D005260:Female; D006526:Hepatitis C / Q000188:drug therapy* / Q000473:pathology / Q000821:virology; D006801:Humans; D015994:Incidence; D017512:Lichenoid Eruptions / Q000139:chemically induced* / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D000069616:Simeprevir / Q000008:administration & dosage / Q000009:adverse effects*; D000069474:Sofosbuvir / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D000998:Antiviral Agents; D000069616:Simeprevir; D000069474:Sofosbuvir
keywords: UV stress; dermatopathology; histopathology