Background and objectives
Hyperbilirubinemia and photosensitivity reactions are the most common manifestations associated with simeprevir-containing regimens. Simeprevir is photodynamically active as sulfonamide; the absorption of ultraviolet ray may show unwelcome adverse effects.
Aim
We aimed to outline the dermatological manifestations associated with management of chronic hepatitis C infection using direct-acting antivirals.
Patients and methods
This study was carried out on chronic hepatitis C patients receiving sofosbuvir and simeprevir, from February 2015 to February 2016 at Assiut Center for Management of viral hepatitis.
Results
Cutaneous manifestations were observed in 16 (0.8%) patients; 11 (69%) of them were males and five (31%) were females. Photosensitivity reactions were the most common dermatological adverse effects observed; they occurred in 10 (62.5%) out of 16 patients. We diagnosed other dermatological manifestations that were not related to photosensitivity reactions in eight patients, such as erythema and scaling of the scrotum that was diagnosed as scrotal psoriasis. Also, we found furuncles, trophic ulcer, purpuric drug eruption, lichen herpeticus, linear ridges in nails with yellowish and blackish discoloration in lateral nail plate, pityrosporum folliculitis, and pigmentation of the lower lip might be drug-induced or lichen. Sustained virological response 12 was the ultimate fate of all the 16 patients. After the end of therapy, all the dermatological manifestations showed complete resolution.
Conclusion
Treatment with direct-acting antivirals may be associated with dermatological adverse effects that resolve with stopping of therapy.