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Correspondence to Dr Rui Arrais de Castro, [email protected]
Background
Hepatitis C virus (HCV) infection is associated with a large spectrum of extrahepatic manifestations that involve primarily the joints, muscle and skin.1 Although a myriad of dermatologic diseases have been linked to chronic HCV infection, the evidence is weak except for the association with mixed cryoglobulinaemia, lichen planus, porphyria cutanea tarda and necrolytic acral erythema.2 3 Some rare reports of association between HCV infection and dermatomyositis have been described, however in none of them was established a clear and direct relation between these two entities.4–8 With this work we reinforce a cause and effect association between HCV infection and dermatomyositis by showing, for the first time, that obtaining sustained virological response (SVR) for HCV infection is preponderant in the control of skin and muscular symptoms of dermatomyositis.
Case presentation
We present a case report of a previously healthy 71-year-old Caucasian woman without any relevant personal or family medical history. In July 2016, she developed an erythematous exanthem with pruritic and scaly lesions located at the torso and upper limbs (figure 1). Some weeks after, she presented involvement of the face and hands with heliotrope and Gottron’s papules, respectively (figure 1). At the same time she developed dysphagia and noticed a significant loss of muscular strength at the root of the limbs. At this point, skin and muscular biopsies were performed. The histological examination confirmed the diagnosis of dermatomyositis. Based on this result, the patient started a course of prednisolone (60 mg/day), with poor symptoms control....