Surreal illustration of Hepatitis B treatment and potential skin reaction

Skin Reactions to Hepatitis B Treatment: What You Need to Know

Jordan Keane in Health & Wellness December 2025 • 4 min read.

"Understanding interferon-induced vasculitis and how to manage skin complications during hepatitis B therapy."

Interferons (IFNs) are a group of proteins crucial for immune response, fighting viruses, and regulating cell growth. They're used to treat various conditions, including hepatitis B. However, IFN therapy can cause side effects, including skin reactions. While most reactions are mild, some can be severe, like local leukocytoclastic vasculitis (LCV) at the injection site.

Cutaneous reactions from IFN treatment can be localized or widespread. Localized reactions at the injection site typically appear as red, itchy patches. In rare cases, a more severe reaction called leukocytoclastic vasculitis (LCV) can occur, leading to skin necrosis (tissue death).

This article explores a rare case of interferon-gamma-induced LCV in a patient with hepatitis B. We'll discuss the symptoms, diagnosis, treatment, and how to minimize such complications. This information is crucial for anyone undergoing IFN therapy and healthcare providers administering it.

Understanding Leukocytoclastic Vasculitis (LCV)

Surreal illustration of Hepatitis B treatment and potential skin reaction

A 19-year-old man with hepatitis B developed painful erythema and necrosis at the interferon-gamma injection site after six months of treatment. The patient had been receiving recombinant IFN-γ (6.0 × 107 units) subcutaneously every other day to decrease viral DNA. Repeating injections near the lesion worsened the pain, erythema, and necrosis.

Doctors diagnosed local LCV based on the cutaneous examination (erythema with central necrosis) and histopathology (angiocentric segmental inflammation with neutrophils).

Angiocentric segmental inflammation
Endothelial cell swelling
Cellular infiltrate composed of neutrophils
Fragmentation of nuclei

The patient was treated with a combination of prednisone (30 mg daily) and colchicine (0.5 mg twice a day), along with changing the injection site to the thighs. The condition improved rapidly within three days. Colchicine was stopped after two weeks, and prednisone was gradually tapered off over two months. At a six-month follow-up, the lesion healed, leaving scars and hyperpigmentation, with no recurrence at the new injection sites.

Managing and Preventing LCV During Interferon Therapy

Cutaneous necrosis is a rare but severe local side effect of IFN treatment. Previous reports suggest discontinuing IFN therapy to resolve LCV lesions. Other treatments include topical care, surgical debridement, and modification of injection sites.

This case demonstrates the potential benefit of systemic corticosteroids and colchicine in managing IFN-induced LCV, without necessarily discontinuing IFN therapy. Changing the injection site is also crucial to prevent recurrence.

Patients undergoing IFN therapy should be educated about potential skin reactions and the importance of varying injection sites. Early recognition and management of LCV can prevent severe complications and improve treatment outcomes.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1590/abd1806-4841.20164985, Alternate LINK

Title: Interferon-Gamma-Induced Local Leukocytoclastic Vasculitis At The Subcutaneous Injection Site

Subject: Dermatology

Journal: Anais Brasileiros de Dermatologia

Publisher: FapUNIFESP (SciELO)

Authors: Fang Wang, Juan-Hua Liu, Yu-Kun Zhao, Di-Qing Luo

Published: 2016-10-01

Everything You Need To Know

What role do Interferons (IFNs) play, and why are they used in treating hepatitis B?

Interferons (IFNs) are proteins vital to the immune system, playing a key role in fighting off viruses and regulating how cells grow. In the context of treating hepatitis B, IFNs are used as a therapy to combat the virus. However, the use of IFNs can lead to various side effects, including skin reactions. These reactions can range from mild, localized issues to severe complications such as leukocytoclastic vasculitis (LCV). Understanding how IFNs work and their potential side effects is crucial for managing the treatment of hepatitis B.

What is Leukocytoclastic Vasculitis (LCV), and how is it related to interferon treatment?

Leukocytoclastic vasculitis (LCV) is a serious skin reaction that can occur as a result of interferon (IFN) therapy. It involves inflammation of the blood vessels, specifically the small vessels. In the case described, LCV manifests as painful erythema (redness) and necrosis (tissue death) at the injection site. The diagnosis of LCV is based on a cutaneous examination and histopathology, which reveals angiocentric segmental inflammation, endothelial cell swelling, and the presence of neutrophils. This condition, though rare, highlights a significant side effect of IFN treatment for hepatitis B.

What are the typical symptoms of LCV that can arise during interferon therapy?

Symptoms of LCV in this context can include painful erythema (redness) and necrosis (tissue death) at the injection site. In the described case, the patient developed these symptoms after six months of interferon-gamma treatment. Repeating injections near the affected area worsened the condition. These symptoms point to local LCV, a severe cutaneous reaction that necessitates careful management. The symptoms are a direct consequence of the body's response to the interferon therapy and can affect the patient's quality of life.

What treatments are available for someone experiencing LCV due to interferon treatment?

The primary treatments for LCV described include a combination of prednisone and colchicine. The patient in the case also had the injection site changed to the thighs. Prednisone is a corticosteroid used to reduce inflammation, while colchicine is often used to manage the inflammatory response in vasculitis. The patient showed rapid improvement within three days of starting the treatment and was gradually tapered off medication. The change in injection site is also a part of the management to prevent further irritation at the original site.

How can the risk of LCV be managed and prevented during interferon therapy?

To minimize the risk of LCV during interferon (IFN) therapy, healthcare providers might consider alternative injection sites and monitor for any adverse cutaneous reactions. Previous reports suggest that discontinuing IFN therapy can resolve LCV lesions in some cases. Additional interventions can include topical care, surgical debridement, and possibly the use of medications to manage the inflammation. Careful monitoring and prompt intervention are crucial for managing and preventing severe skin complications associated with interferon treatment.