{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T11:10:01Z","timestamp":1756293001919,"version":"3.44.0"},"reference-count":9,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,7,11]]},"abstract":"<jats:p>There are rare reports of association between hepatitis C virus (HCV) infection and dermatomyositis although cause and effect remains to be proven. We present a clinical case with a probable cause and effect association between these two entities. A 71-year-old woman developed an erythematous exanthem with pruritic and scaly lesions located at the torso and upper limbs associated with heliotrope and Gottron\u2019s papules. At the same time, she notice a significant loss of muscular strength. Skin and muscular biopsies made the diagnosis of dermatomyositis and the patient started with prednisolone (60\u2009mg\/day) with poor symptoms control. Paraneoplastic syndrome, HIV, hepatitis B virus and syphilis infections were excluded. HCV serology was positive, with a viral load of 58 159 IU\/mL (genotype 1a). Therefore, the patient underwent a 12-week treatment with grazoprevir 100 mg and elbasvir 50\u2009mg achieving a sustained virological response with regression of skin lesions and complete recovery of muscular strength (photodocumented before\/after treatment). Additionally it was possible to reduce prednisolone dosage to 5\u2009mg\/day.<\/jats:p>","DOI":"10.1136\/bcr-2018-225817","type":"journal-article","created":{"date-parts":[[2018,7,26]],"date-time":"2018-07-26T00:35:39Z","timestamp":1532565339000},"page":"bcr-2018-225817","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Hepatitis C virus infection: \u2018beyond the liver\u2019"],"prefix":"10.1136","volume":"2018","author":[{"given":"Rui","family":"Arrais de Castro","sequence":"first","affiliation":[{"name":"Gastroenterology, Instituto Portugues de Oncologia do Porto Francisco Gentil, EPE, Porto, Porto, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula","family":"Vilas","sequence":"additional","affiliation":[{"name":"Internal Medicine, Centro Hospitalar Lisboa Norte, EPE, Lisboa, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jo\u00e3o","family":"Borges-Costa","sequence":"additional","affiliation":[{"name":"Unidade de Investiga\u00e7\u00e3o em Dermatologia, Cl\u00ednica Universit\u00e1ria de Dermatologia de Lisboa, Faculdade de Medicina da Universidade de Lisboa, CHLN, IMM, Lisboa, Portugal"},{"name":"Instituto de Higiene e Medicina Tropical, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"Tato Marinho","sequence":"additional","affiliation":[{"name":"Hepatology Unit, Hospital de Santa Maria, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,7,25]]},"reference":[{"key":"2025082703513329000_2018.jul25_1.bcr-2018-225817.1","first-page":"1149","article-title":"HCV infection and extrahepatic manifestations","volume":"50","author":"Nocente","year":"2003","journal-title":"Hepatogastroenterology"},{"key":"2025082703513329000_2018.jul25_1.bcr-2018-225817.2","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/j.cld.2017.03.010","article-title":"Dermatologic manifestations of chronic hepatitis C infection","volume":"21","author":"Sayiner","year":"2017","journal-title":"Clin Liver Dis"},{"key":"2025082703513329000_2018.jul25_1.bcr-2018-225817.3","doi-asserted-by":"publisher","DOI":"10.1016\/S0046-8177(03)00193-X"},{"key":"2025082703513329000_2018.jul25_1.bcr-2018-225817.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0049-0172(97)80005-4"},{"key":"2025082703513329000_2018.jul25_1.bcr-2018-225817.5","first-page":"197-201","article-title":"HCV and dermatomyositis: report of 5 cases of dermatomyositis in patients with HCV infection","volume":"18","author":"Fiore","year":"1996","journal-title":"Riv Eur Sci Med Farmacol"},{"key":"2025082703513329000_2018.jul25_1.bcr-2018-225817.6","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1002\/art.1780400232","article-title":"Dermatomyositis, hepatocarcinoma, and hepatitis C: comment on the article by Weidensaul et al","volume":"40","author":"Gomez","year":"1997","journal-title":"Arthritis Rheum"},{"key":"2025082703513329000_2018.jul25_1.bcr-2018-225817.7","first-page":"834","article-title":"Chronic hepatitis C virus infection associated with dermatomyositis and hepatocellular carcinoma","volume":"27","author":"Kee","year":"2004","journal-title":"Chang Gung Med J"},{"key":"2025082703513329000_2018.jul25_1.bcr-2018-225817.8","doi-asserted-by":"crossref","first-page":"1641","DOI":"10.3748\/wjg.v12.i10.1641","article-title":"Dermatomyositis associated with hepatocellular carcinoma in an elderly female patient with hepatitis C virus-related liver cirrhosis","volume":"12","author":"Toshikuni","year":"2006","journal-title":"World J Gastroenterol"},{"key":"2025082703513329000_2018.jul25_1.bcr-2018-225817.9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/jscr\/rjv075","article-title":"Dermatomyositis presenting as a paraneoplastic syndrome with resolution of symptoms following surgical management of underlying breast malignancy","volume":"2015","author":"Luu","year":"2015","journal-title":"J Surg Case Rep"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-225817","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T10:51:39Z","timestamp":1756291899000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-225817"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,7,25]]},"references-count":9,"alternative-id":["10.1136\/bcr-2018-225817"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-225817","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2018,7,25]]}}}