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We read with interest the article by Moore et al¹ titled "Severe, Generalized Nummular Eczema Secondary to Interferon Alfa-2b Plus Ribavirin Combination Therapy in a Patient With Chronic Hepatitis C Virus Infection." We report 2 additional cases of severe generalized nummular eczema developing after combination immunotherapy for chronic hepatitis C virus (HCV).

Report of Cases

Case 1

A 39-year-old white man with a medical history notable for treated malaria and dengue fever as well as chronic HCV infection was started on combination treatment for his HCV with peginterferon alfa-2b injections weekly and ribavirin administered orally twice daily. Four months after therapy was initiated, the patient developed a diffuse intensely pruritic rash unresponsive to oral diphenhydramine hydrochloride. He had no personal or family history of atopy or other dermatologic disease. Combination immunotherapy was stopped because of this eruption, with subsequent gradual improvement of skin lesions and pruritus. Physical examination findings 2 weeks later revealed nummular erythematous . . . [Full Text of this Article]

Case 2

Comment

AUTHOR INFORMATION
Yang Shen, MD; Josie Pielop, MD; Sylvia Hsu, MD