Boceprevir and telaprevir are 2 specific inhibitors of the hepatitis C (HCV) serine protease 3. Cutaneous side effects have been reported with high frequency, essentially rash, and dry skin. We report a case of drug rash with eosinophilia and systemic symptoms (DRESS) due to boceprevir. A 56-year-old African woman with chronic hepatitis C complicated with cirrhosis and cryoglobulinemia received pegylated interferon alfa-2a (PegIFN) and ribavirin (RBV) for 4 weeks and then boceprevir was added. She was also co-infected with HIV state A2. Eight weeks after adding boceprevir she developed a generalized maculopapular exanthema with fever, facial oedema, apparition of lymph node and alteration of the general state. She presented an eosinophilia (up to 3.0 × 10(9)cells/L), no biological inflammatory syndrome. The computed tomography revealed several lymph nodes located in the abdominal and inguinal areas. The cutaneous biopsy was consistent with a drug rash reaction. The HCV treatment was stopped and the patient was treated with topical steroids. Cutaneous and systemic symptoms disappeared in few weeks. Boceprevir was considered the culprit drug. We report to our knowledge the first case of DRESS due to boceprevir.

译文

Boceprevir和telaprevir是丙型肝炎 (HCV) 丝氨酸蛋白酶3的2种特异性抑制剂。据报道,皮肤副作用高频率,基本上是皮疹和皮肤干燥。我们报告了一例因boceprevir引起的嗜酸性粒细胞增多和全身症状 (DRESS) 的药疹。一名56岁的慢性丙型肝炎并发肝硬化和冷球蛋白血症的非洲妇女接受聚乙二醇化干扰素alfa-2a (PegIFN) 和利巴韦林 (RBV) 治疗4周,然后加入boceprevir。她还与HIV状态a2共同感染。添加boceprevir八周后,她出现了广泛性斑丘疹,发热,面部水肿,淋巴结出现和一般状态改变。患者出现嗜酸性粒细胞增多 (最多3.0 × 10(9) 个细胞/L),无生物性炎症综合征。计算机断层扫描显示位于腹部和腹股沟区域的几个淋巴结。皮肤活检与药疹反应一致。HCV治疗停止,患者接受局部类固醇治疗。皮肤和全身症状在几周内消失。Boceprevir被认为是罪魁祸首。据我们所知,由于boceprevir,我们报告了第一例着装。

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