A 47-year-old man presented with intense pruritus of the skin that resulted in the appearance of an erythematous lesion, with edges similar to the left arm and irregular, and slightly superficial lesions appear on the left arm.
A few months before she started treatment for hepatitis C with 135 mg of interferon alfa-2a weekly, administered subcutaneously and ribavirin, 1200 mg/day orally.
On physical examination, a pruritic eczematous plaque was found in the lower third of the left arm.
See picture.
Lesions of similar characteristics are observed, of diverse sizes that are distributed by the lower and upper limbs, as well as by the thorax, face and auricular pavilions.
The patient's general condition is good, blood count and blood biochemistry are normal.
An incisional biopsy of the upper edge of the lesion located in the left arm was performed.
The pathology laboratory reports that it is a psoriasiform and spongy dermatitis with formation of intracorneal blister with neutrophils.
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The diagnosis of generalized nummular eczema secondary to the ingestion of interferon alfa-2a and ribavirin for the treatment of hepatitis C is established. After consultation with the Digestive specialist, it is decided to withdraw the topical treatment 25 mg.
The cutaneous condition resolves 15 days without complications.
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Diagnosis: Generalised nummular eczema secondary to interferon alfa-2a and ribavirin
