CUTANEOUS MANIFESTATION OF ACUTE HEPATITIS B VIRUS INFECTION: A CASE REPORT AND LITERATURE OVERVIEW

Authors

  • Martina Gjorgjievska Kamceva “Clinical Hospital” – Stip, North Macedonia
  • Strahil Gazepov University "Goce Delcev” Shtip, North Macedonia

Keywords:

hepatitis B virus infection, skin manifestations

Abstract

Recognition of the extrahepatic unique dermatologic manifestation associated with the acute hepatitis B virus infection is important in order to obtain proper and timely diagnosis and treatment of the patient. Hepatitis B virus infections is not so rare disease, but it can still be a global problem because in addition to the characteristic clinical symptoms, including yellowing of the skin and eyes, dark urine, extreme fatige, abdominal pain, vomitus and nausea, most people do not experience any symptoms when newly infected ordevelop less specific symptoms such as skin manifestations. Acute HBV infection is often a mild, asymptomatic, subclinical illness that frequently passes without detection in approximately two thirds of cases. Symptoms of acute HBV infection are often nonspecific, and diagnosis is secured through serologic testing for immunoglobulin M antibody to hepatitis B core antigen. The time frame for clinical incubation of acute HBV infection averages 2—3 months, however, this time frame can range from 1—6 months after exposure. There is some evidence that the time of incubation correlates with the size of the viral load.HBV primarily affects the hepatocytes, but there are studies showing that other organs can also be affected. Extrahepatic manifestations are not specific for HBV, the pathophysiology of such changes is the result of reactions of immune complexes that manifest symptoms in other organs. We present the case of a 30-year old women who was first diagnosed with Keratosis pillaris. The patient comes for the first time for an examination at the Dermatovenerology department at Clinical hospital, Shtip, with itching in the area of the lower extremities, the gluteal region and occasionally on the upper limbs, she does not give any information about other symptoms and signs, the changes persisted for about two weeks. On examination, small popular efflorescence are visible, slightly reddened, the skin is dry and rough to the touch. Antihistamine, corticosteroid and emollient therapy was given. After two weeks, the patient came for a follow-up examination without improvement of the symptoms, here the information is given that the itching is more intense every day. Routine blood test were performed which showed increased values of alanine aminotransferase 529 IU/L (43 IU/L), and aspartate transaminase 589IU/L(45IU/L). Future investigations establish the diagnosis: Acute infection with hepatitis B virus. The patient was sent to an Infectologist who confirm the diagnosis and prescribed electrolyte and vitamins intravenous therapy and hepatoprotectors. After few days the skin manifestation was disappeard. But the patient was in a overlap period for a long time because the values of antibodies and antigen of the hepatitis B virus were elevated.

References

Allyson M Jones, K. Warken, S. K. Tyring, (2019 ) The cutaneous manifestation of viral hepatitis.

Caputo R, Gelmetti C, Ermacora E, et al. ( 1992 ) Gianotti-Crosti syndrome: a retrospective analysis of 308 cases. J Am Acad Dermatol, 26:207–210.

Czaja AJ, ( 1997 ) Extrahepatic immunologic features of chronic viral hepatitis. Dig Dis Sci, 15:125–144. Excellent review of various autoimmune phenomena in patients with chronic HCV infection.

C. Mazzaro, A.Zanieer, S. Sciascia, D. Serrain, ( 2022 ). Extrahepatic Manifestations of Chronic HBV Infection and the Role of Antiviral Therapy, 33081 11(21), 6247;

Durand JM, Lefevre H, ( 1991 ) Cutaneous vasculitis and cryoglobulinemia type II associated with hepatitis C virus infection. Lancet, 337:499–500.

Emanuele Cozzani , Astrid Herzum , Martina Burlando , Aurora Parodi, (2021 ) Cutaneous manifestations of HAV, HBV, HCV, Feb;156(1):5-12.

Matthew R. Kappus, Richard K. Sterling ( 2013) Extrahepatic Manifestations of Acute Hepatitis B Virus Infection, 123-126

McMahon BJ, Alberts SR, Wainwright RB, et al, ( 1990 ) Hepatitis B-related sequelae: prospective study in 1400 hepatitis B surface antigen-positive Alaska native carriers. Arch Intern Med 150:1051–1054.

McMahon BJ, Alward WL, Hall DB, et al. ( 1985 ) Acute hepatitis B virus infection: relation of age to the clinical expression of disease and subsequent development of the carrier state. J Infect Dis ;151:599–603.

N T Pyrsopoulos , K R Reddy, ( 2021 ) Extrahepatic manifestations of chronic viral hepatitis, Feb;3(1):71-8.

Nikolaos T. Pyrsopoulos, MD and K. Rajender Reddy, MD, ( 2021 ) Extrahepatic Manifestations of Chronic Viral Hepatitis, 3:71–78 Current Science Inc. ISSN 1522–8037

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5665317/, 2024

Downloads

Published

2024-03-31

How to Cite

Gjorgjievska Kamceva, M., & Gazepov, S. (2024). CUTANEOUS MANIFESTATION OF ACUTE HEPATITIS B VIRUS INFECTION: A CASE REPORT AND LITERATURE OVERVIEW. KNOWLEDGE - International Journal , 63(4), 379–382. Retrieved from https://ikm.mk/ojs/index.php/kij/article/view/6706

Most read articles by the same author(s)

1 2 3 4 5 > >>