Hepatitis

• Hepatitis A
• Icteric
• Maculopapular rash in the pre-icteric phase

• Hepatitis B
• Generalidades
• Hepadnavirus
• DNA Virus → integrates in genome → primary hepatocellular carcinoma
• Cutaneous manifestations
• Vasculitis
🚗
Cutaneous Small Vessel Vasculitis (CSVV)
📿
Polyarteritis nodosa
• Premonitory syndrome of hepatitis B (pre-icteric phase)
• Classic Caroli triad: headache, urticaria, arthralgia
• Mixed cryoglobulinemias (type 2 or 3)
❄️
Cryoglobulines
Acrodermatite Papulosa Infantil (Gianotti Crosti Syndrome)
• Late-onset cutaneous porphyrias
Porphyria Cutanea Tarda (PCT)

• Hepatitis C
• Generalidades
• Flavivirus
• RNA virus → mutations allow HCV to evade immune response → chronic hepatits more common than hepatitis B (80% vs. 5%)
• Cutaneous manifestations
• Mixed cryoglobulinemias (type 2 or 3)
❄️
Cryoglobulines
• Vasculitis
🚗
Cutaneous Small Vessel Vasculitis (CSVV)
📿
Polyarteritis nodosa
• Late cutaneous porphyrias
Porphyria Cutanea Tarda (PCT)
💜
Idiopathic Lichen Planus
• Pruritus
• Acral necrolytic erythema
• Rare
• Well, defined, hyperkeratotic plaques with a peripheral macular anderythematous ring, secondary lichenification and hyperpigmentation
• Most respond to zinc supplementation

• Hepatitis D
• Defective, needs the surface antigen of HBV
• Fulminant hepatitis

• Hepatitis E
• Normal patients: mild
• Pregnant patients: severe hepatitis

Hepatitis B/C

• Manifestações cutâneas
• Vasculite de pequenos vasos (B,C)
• Vasculite crioglobulinêmica (C>B)
• Urticarial vasculitis (B,C)
• Polyarteritis nodosa (B [clássico]>C)
• Livedo reticularis (C)
• Serum-sickness-like reaction (B,C)
• Urticária (B,C)
• Gianotti-Crosti syndrome (B>C)
• Necrolytic acral erythema (C)
• Porphyria cutanea tarda (B,C)
• Pruritus (B,C)
• Lichen planus - particularly erosive oral disease (C)
• Sarcoidosis (with interferon and/or ribavirin therapy; C>B)
• Erythema multiforme (B, C)
• Erythema nodosum (B>C)