clobetasol and Hepatitis-C

Bullous pemphigoid (BP) is an autoimmune disease with chronic, recurrent bullous eruptions. BP has been reported to be associated with drugs, physical stimuli, malignancies, and immune abnormalities. Its association with renal transplant is rare and only four cases have been reported. We present a case of BP in a 52-year-old man with chronic hepatitis B and C infection who underwent a cadaveric renal transplant 13 years earlier. His graft was still functioning well when BP appeared. The occurrence of BP in our patient might be a result of drugs (furosemide or tacrolimus), viruses, or renal allograft. As the patient was receiving regular T-cell immunosuppressant therapy, his BP lesions were recalcitrant to corticosteroid treatment. We discuss the pathogenesis and treatment of such patients.

Topics: Administration, Cutaneous; Anti-Infective Agents; Clobetasol; Dapsone; Doxycycline; Fatal Outcome; Glomerulonephritis, IGA; Glucocorticoids; Hepatitis B; Hepatitis C; Humans; Kidney Transplantation; Male; Methylprednisolone; Middle Aged; Niacinamide; Pemphigoid, Bullous; Plasmapheresis; Vitamin B Complex

The ulcerative variant of lichen planus (LP) commonly involves the oral mucosa but is uncommon and difficult to treat when located on other areas. We describe an unusual case of ulcerative LP involving several surfaces, including the palms and scrotum, in a 50-year-old man with hepatitis C. The patient was recalcitrant to treatment with conventional therapy but obtained clearance with a sustained response using low molecular weight heparin (LMWH). This treatment is an option for patients with LP who are not ideal candidates for standard therapy.

Topics: Anti-Inflammatory Agents; Anticoagulants; Clobetasol; Genital Diseases, Male; Hand Dermatoses; Heparin, Low-Molecular-Weight; Hepatitis C; Humans; Immunosuppressive Agents; Lichen Planus; Male; Middle Aged; Scrotum; Skin Ulcer; Tacrolimus