A rapid favorable outcome after sofosbuvir induced leucocytoclastic vasculitis.

Abstract

Background: Sofosbuvir, a very effective new direct-acting antiviral agent (DAA), has revolutionized the therapeutic management of people infected with hepatitis C virus. It has a low reported rate of side effects. Leukocytoclastic vasculitis can be associated with hepatitis C but can also be induced by many drugs. We describe a case of leucocytoclasic vasculitis induced by Sofosbuvir that resolved 3 days after drug withdrawal. We observed a temporal relationship between the treatment and the onset of vasculitis. We emphasize the multidisciplinary approach to patients with hepatitis C to make the difference between drug-induced skin damage and damage caused by the virus itself. Case presentation: A 61-year-old woman, with a history of hepatitis C virus infection started treatment with the combination ledipasvir sofosbuvir in June 2020, 400 mg per day. Five weeks later, she developed a slightly itchy erythematous and symmetrical rash on lower members. The patient initially suspected the treatment and she stopped it. Histological finding revealed a diffuse neutrophile infiltration of vessel walls confirming leukocytoclastic vasculitis. These lesions disappeared completely three days after drug withdrawal without any symptomatic treatment. Conclusions: Sofosbuvir is one of the several recent drugs that should be prone to further attention.