Hepatitis C is a viral disease of the liver. This disease is usually spread via contact with infected blood, but there are other ways in which a person can become infected as well. Having unprotected sex puts you at risk of getting infected with hepatitis C. It is also possible for an infection to spread to a baby from an infected mother. Although blood, blood products and organs are routinely tested for a number of infectious diseases, getting a blood transfusion or an organ transplantation can also be a route of transmission, especially in developing countries.
The most common ways of getting a hepatitis C infection are:
- Sharing equipment, such as needles and syringes, when abusing drugs
- Sharing razors, toothbrushes and other items that may contain microscopic traces of blood
- Getting a tattoo or a piercing in unsafe and unsanitary conditions
It is important to note that hepatitis C cannot be spread by sharing food or water, nor by hugging, kissing, or through breast milk.
Hepatitis C can take both an acute and a chronic form. In the case of an acute hepatitis C infection, the virus is cleared out of the organism within six months, and the symptoms are usually mild. On the other hand, the chronic form of hepatitis C can last for months or years, and can sometimes even be lifelong. If left untreated, this form of the disease can cause fatty liver disease, cirrhosis, and even liver cancer.
Aside from liver, several other organs have been known to be affected by this illness in different ways. Skin manifestations of hepatitis C are quite common, and about 17 percent of patients experience some of the following conditions:
- Mixed cryoglobulinemia
- Porphyria cutanea tarda
- Lichen planus
- Pruritus
- Psoriasis
- Necrolytic acral erythema
- Vitiligo
- Chronic urticaria
- Pyoderma gangrenosum
- Erythema nodosum
- Erythema multiforme
1. Mixed cryoglobulinemia
Cryoglobulinemia is a condition in which our blood contains certain proteins in larger quantities than normal. The presence of these proteins triggers an immune reaction, especially in smaller blood vessels, and causes an inflammation, called vasculitis. Vasculitis can affect many different organs, such as the heart, kidneys or even the brain, but skin lesions are most easily noticed. It is believed that the constant presence of the hepatitis virus affects our immune system, making it produce a large quantity of immunoglobulins, which are proteins our body uses to fight diseases. Mixed cryoglobulinemia can cause skin ulcers and even necrosis. Antiviral therapy for hepatitis can help with this condition in some cases.
2. Lichen planus
Lichen planus is an autoimmune condition that affects the skin, the mucosa in both mouth and genitalia, esophagus, respiratory tract, urinary tract, the eyes, as well as the hair follicles and nails. It is believed that, when cells in the skin and mucosa (basal keratinocytes) present certain molecules (such as viral antigens) to white blood cells, it triggers an immune response in those cells, which causes inflammation and lichen planus. Oral lichen planus is the most common form of this condition, in the case of hepatitis C patients.
3. Porphyria cutanea tarda
Porphyira is a condition in which molecules called porphyrines build up in the skin, resulting in blisters and lesions if the skin is exposed to the sun. This condition is caused by the deficiency of a certain enzyme (UROD), which helps in the metabolism of heme, a part of hemoglobin molecule. The lack of this enzyme stops the decomposing of heme, and the byproducts of the metabolism build up in the skin.
A hepatitis C infection can trigger this condition, especially if other factors, such as alcoholism, smoking, or genetic factors are present. All of these factors contribute to the lower activity of the UROD enzyme, which leads to porphyria.
Treatment for this condition includes staying away from the sun, anti-malarial drugs and phlebotomy, which is basically blood draining, the purpose of which is lowering the levels of iron in the organism, since elevated iron levels lower the activity of the UROD enzyme.