What autoimmune factors may be present on physical exam of patients with hepatitis C (Hep C)?

Updated: Apr 02, 2020
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD  more...
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Answer

Autoimmune factors, not further categorized, are as follows:

  • Behçet disease is described as presenting with oral, eye, and genital ulcerations that result from an unknown vasculitic process.

  • Canities may occur. Stories abound of people's hair suddenly turning white. Chronic hepatitis C infection is one of the causes of the sudden disruption of the melanizing function of follicles.

  • Prurigo nodularis clinically appears as heaped keratotic masses on a thickened inflammatory base. Relentless scratching eventually causes excoriated masses in areas that the patient can easily reach; such areas include the shoulders, arms, upper part of the trunk, thighs, and anterior parts of the lower legs.

  • See Lichen Planus for a discussion of the condition.

  • Scarring alopecia and sclerodermatous changes may occur on the hands, back, and chest. [83] A patient presented with erosions and blisters on the hands and back and sclerodermoid thickening and scarring of this skin in the setting of PCT.

  • Immune thyroiditis is the most common extrahepatic manifestation of chronic hepatitis C infection. Findings depend on the state of the thyroid destructive process. Findings of a diffusely enlarged gland and hyperthyroidism are noted early. A normal size and a granular feel as well as normal function are noted at one point, and, later, hypothyroidism with a shrunken gland is found because much of the thyroid is destroyed.

  • In thrombocytopenia, low platelet counts result in the spontaneous asymptomatic appearance of flat areas of petechiae, purpura, and ecchymosis of the skin. Dependent areas are often involved first. Easy bruising is noted.

  • In vitiligo, areas of complete loss of pigmentation occur, and white spots develop on the skin.

  • Symmetric polyarthritis with livido reticularis is noted. [79]

  • Generalized granuloma annulare with HCV infection disappears with appropriate treatment of chronic hepatitis C infection. [78]


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