hepatitis C

Question 1

majority of transmission are thru

Answer 1

Parenterally transmitter IV drug use.

Question 2

most common clinical presentation

Answer 2

plpable purpura on the lower extremities (90% of cases)

leg ulcers 10-20%

HCV- almost twice as likely to dev psoriasis spec men over 40 yo.

Question 3

rare condition assoc w HCV

Answer 3

NAE NECROLYTIC ACRAL ERYTHEMA

Acral dist.
clinical lesions are painful or pruritic keratotic well defined plaques w raised red scaly borders or diffuse hyperkeratosis.
erosion and flaccid blisters may occur.

Question 4

H

Answer 4

Necorissi or the superficial posrtion of epidermis.  
hyperkeratosispapillomatosis 
loss of granular cell layer 
parakerstosis 
intraepid spongiotic foci.

Question 5

tx

Answer 5

INF alpha and ribavirin.
may be complicsted w eczematous eruption and pruritus in about 8% of pxs and severe pruritus in about 1%.
therse eczematous eruption typically begin 2-4 mos after initiation of tx.

H: Spongiotic dermatitis.
eruptionresokbes com after tx is stopped for 2-3 weeks but will recur when tx is restarted.

aggresive tx w antihistamine emollient top potent steroid usually control eczema.

Teleprevir is an hcv protease inh - agent to enhance response of hcv to tx. higher rate of adv skin rxn (60-80% pxs)