An Assessment of the Prevalence of Psoriasis in Patients with Hepatitis C

Psoriasis is a chronic, immune-mediated disease characterized by erythematous,
scaly plaques on the skin. It is estimated that psoriasis affects 2% of the
general population. Psoriasis is thought to be an autoimmune disorder in which
the body attacks a currently unknown antigen in the skin. Most patients have a
genetic predisposition to develop psoriasis, and triggering factors include
infections, medications, or physical trauma to the skin.

Interferon is a naturally existing glycoprotein in the body. It possesses
immune modulating properties and is commonly used as a treatment for many
tumors and infections, including hepatitis C. Patients on interferon therapy
are at risk for developing autoimmune conditions and exacerbation of
pre-existing conditions. Psoriasis is among these conditions, and has been
reported both to be exacerbated and newly develop in patients on interferon
therapy. Psoriasis often improves when the interferon treatment is stopped.

This single-center investigation will assess the prevalence of psoriasis in a
population of patients with hepatitis C and compare the prevalence in those
patients receiving pegylated interferon-* therapy to those not receiving
pegylated interferon-* treatments.

A goal of 80 consecutive hepatitis C patients,with and without pegylated
interferon-* treatment, will be evaluated by the department of dermatology at
the AMC directly after the visit with the hepatologist. These patients will
sign informed consent.. They will be given full body skin examinations to
evaluate for the presence of psoriasis.
The pegylated interferon-* must had been given for at least one dose, within
the last 6 months, as we would expect to see psoriasis persist in that period
of time. The dose, type and duration of pegylated interferon-* treatment will
be documented, as well as data about a history of diagnosed psoriasis and
treatment.
A detailed medical history will be taken and a full-body skin examination will
be performed, with special emphasis on typical sites of involvement with
psoriasis, such as elbows and knees, looking for erythema with squamae. The
examination of the skin will be standardized. The observer was blinded as to
whether or not the patients were treated with pegylated interferon-*.
If the skin examination reveals the presence of any kind of psoriasis,
photographs will be taken of the affected area, as a record . In case of doubt,
review by an second dermatologist will be performed. If the second
dermatologist thinks it is questionable too, patients will be scored as not
having psoriasis in the analysis.
The study procedures will include a review of the charts of the patients in the
clinic to evaluate the number of patients with the diagnosis of psoriasis, as
well as which of these patients are on pegylated interferon-* therapy.

There are no risks associated with patient participation in this study since no
study drugs will be given and no histology will be applied.
The data will give a contribution to the knowledge of developing or
exacerbation of psoriasis in treatment with pegylated interferon-*.