title: Leg ulcer as a manifestation of eosinophilic vasculitis in a patient with hepatitis C virus infection, medicated with pegylated interferon/ribavirin.
abstract: Cryoglobulinaemic vasculitis is a complication of hepatitis C virus (HCV) infection, responding to treatment with pegylated interferon (peg-IFN)/ribavirin (RIB), but vasculitis may first appear after treatment with peg-IFN/RIB. A 35-year-old man with HCV infection presented to our department with a 2-month history of a 3.3 × 3 cm ulcer localised on the right shin, with a regular border, on a violaceous base. Histopathological examination revealed a leucocytoclastic vasculitis, rich in eosinophils. The patient had been treated with peg-IFN/RIB 10 months prior and treatment was discontinued after 2 months because of the appearance of arthralgias and neuropathy. Laboratory investigations revealed positive cryoglobulins, elevation of rheumatoid factor and reduction of C4 after treatment with peg-IFN/RIB. Dressings with a hydrocellular foam were placed and after 2 months the ulcer resolved. We presented this case because of the rarity of development of a cryoglobulinaemic vasculitis in a patient with HCV infection, previously treated with peg-IFN/RIB.
authors.affiliation: Department of Dermatology and Venereology, Hospital de Braga, Braga, Portugal.
authors.forename: Cristina
authors.initials: C
authors.lastname: Resende
authors.affiliation: Department of Dermatology and Venereology, Hospital de Braga, Braga, Portugal.
authors.forename: Teresa
authors.initials: T
authors.lastname: Pereira
authors.affiliation: Department of Dermatology and Venereology, Hospital de Braga, Braga, Portugal.
authors.forename: Filipa
authors.initials: F
authors.lastname: Ventura
authors.affiliation: Department of Dermatology and Venereology, Hospital de Braga, Braga, Portugal.
authors.forename: Celeste
authors.initials: C
authors.lastname: Brito
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000009:adverse effects* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004802:Eosinophilia / Q000150:complications*; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects* / Q000627:therapeutic use; D007871:Leg Ulcer / Q000209:etiology*; D008297:Male; D012254:Ribavirin / Q000009:adverse effects* / Q000627:therapeutic use; D014657:Vasculitis / Q000150:complications*
chemical_list: D000998:Antiviral Agents; D016898:Interferon-alpha; D012254:Ribavirin