A case of cutaneous vasculitis with underlying hepatitis C and cryoglobulinaemia

We report a 74 year old lady presenting with cutaneous leukocytoclastic vasculitis. The underlying aetiology was established as chronic hepatitis C infection with associated cryoglobulinaemia. This presented clinically as recurrent cutaneous vasculitic eruptions with absence of any other clinical manifestations. In this case, antiviral treatment to eradicate hepatitis C virus (HCV) was deemed inappropriate given the low necroinflammatory score determined by liver biopsy, absence of other systemic sequelae of cryoglobulinaemia and potential risks of therapy given her age. Currently her cutaneous disease is relatively well controlled with intermittent application of potent topical steroids. This case highlights the need to consider hepatitis C as a potential aetiological factor in all patients with cutaneous vasculitis. We suggest that viral hepatitis screening should be routine in all patients presenting with cutaneous vasculitis.