Local treatment of non healing leg ulcers in a patient with hepatitis C virus infection.

Dear Editors, Infection with hepatitis C virus (HCV), a blood-borne agent, is transmitted by apparent and inapparent parenteral procedures, frequently associated with autoimmune extrahepatic complications (1). Skin is one of the most frequently affected organs and the major skin diseases frequently associated with HCV infection include mixed cryoglobulinemia, porphyria cutaneatarda, palpable purpura, lichen planus cutaneous and necrotising vasculitis, often with very painful leg ulcers. Other skin disorders that may also be linked to hepatitis C are Behçet syndrome, erythaema multiforme and nodosum, malacoplakia, urticaria and pruritus (2). The leg ulcers due to cutaneous vasculitis may or may not be associated to cryoglobulins (3). These are chronic, nonhealing ulcers difficult to treat with a significant impact on psychosocial aspects as well as on one’s physical well-being (4,5). We present a case of a 57-year-old female ex-addict who has been suffering from HCV infection for 10 years, cardiopathy, hypertension and arterio-venous pathology. She presented with non-healing ulcers over her right and left thighs for a duration of 3 years (Figure 1). During the 3 years prior to the admission, the patient was treated monthly by her general practitioner and twice a week by a home-care team. The patient was visited at first, in 2011, in our Ambulatory