RSS Feeds
Update in Dermatology
- Rebecca A. Kazin, MD;
- Nancy R. Lowitt, MD; and
- Mark H. Lowitt, MD
- From Johns Hopkins University School of Medicine and University of Maryland School of Medicine, Baltimore, Maryland.
The recent expansion of knowledge about dermatology will substantially affect the practice of internal medicine. The natural histories of several common and important dermatologic diseases have been better elucidated, and a wide spectrum of new therapeutic options has emerged for some of the most vexing diseases. We highlight and discuss 10 articles from the past 2 years that illustrate progress in dermatologic areas of interest to the internist.
As the number of patients infected with the hepatitis C virus (HCV) continues to increase, early diagnosis remains paramount. Recent investigations suggest that two cutaneous diseases, lichen planus (1) and porphyria cutanea tarda (2), may signal the presence of HCV infection. However, HCV testing in patients with chronic urticaria may be unnecessary.
Hepatitis
Chronic Urticaria Not Found To Be an Initial Presentation of HCV or HGV Infection
In 1996, Kanazawa and colleagues (3) suggested that chronic urticaria was linked to HCV infection. In that trial, 24% of 79 Japanese patients with urticaria were found to be infected with HCV. However, three subsequent European trials noted much lower rates of infection in patients with chronic urticaria (4–6). None of the studies included appropriate comparison groups. Recently, Cribier and associates completed the first prospective case–control study of the prevalence of HCV in patients with chronic urticaria. Hepatitis G virus (HGV), a single-stranded RNA virus transmitted by blood transfusion, was also studied because it is a frequent co-infection with HCV. No known studies have examined its prevalence and possible correlation with chronic urticaria.
One hundred ten consecutive patients with classic urticaria lasting longer than 2 months were compared with 110 age- and sex-matched controls from the same institution during the same time period. Patients with known hepatitis or HIV infection were excluded. Most of the controls were being observed for cutaneous malignant tumors. All patients were tested for HCV antibodies and HCV RNA to rule out false-negative results …
