Photo-accentuated eruption and vascular deposits of immunoglobulin A associated with hepatitis A virus infection

Skin rash associated with hepatitis A virus infection has rarely been repor ted. We describe a patient with hepatitis A virus infection who presented a rubelliform rash markedly accentuated in sun-exposed areas; direct immunof luorescence studies of the lesion revealed immunoglobulin tig) A deposition on the endothelial cells in the upper dermis. Oral rechallenge tests of th e previously administered drugs failed to reproduce the eruption. The prefe rential setting of immune complexes containing IgA at sites of sun exposure and sunlight as a triggering factor might have been responsible for the de velopment of the eruption in this patient. Eruptions associated with hepati tis A virus infections may be more frequent than commonly thought. Because of difficulty to exclude the possibility of drug eruptions, these cases mig ht have been overlooked. In patients with such a disorder, a careful clinic al workup such as IgM antibodies for hepatitis A virus at diagnosis and dur ing follow-up is especially recommended. Copyright (C) 2000 S. Karger AG. B asel.