Background and study aim
Concomitant hepatitis C virus (HCV) infection and psoriasis vulgaris (PV) are not uncommon coexisting diseases, especially in areas with high viral hepatitis endemicity. To date, data about the interaction between both diseases are scarce. Therefore, we aimed to describe the possible interplay between the HCV viral load and psoriatic activity in concomitant Egyptian diseased patients.

Patients and methods
Between December 2011 and August 2013, all psoriatic patients attending Assiut University Hospital outpatient clinics were tested for HCV serologic assay. Patients with positively coexisting diseases were further reevaluated for psoriasis area severity index (PASI) score assessment, liver function tests, HCV-RNA-polymerase chain reaction (PCR) assays, and sonographic examination of the liver. For comparative purposes, another matched group (n = 26) with psoriasis only (HCV-negative group) was enrolled as a control.

Results
During the period of the study, 20 patients with concomitant PV and HCV infection (HCV-positive group; 50% males, mean age of 44.15 ± 10.66 years) were recruited. The mean PASI score was 44.75 ± 10.38 and clinical signs of liver dysfunction were observed in 40% (n = 8), 100% had abnormal liver function tests (n = 20), and 75% had sonographic findings of cirrhosis (n = 15). The PASI score was significantly higher in the HCV-positive psoriatic group compared to the HCV-negative control (p < 0.001). Significant correlations were detected between the PASI score and the viral loads, and also with alanine aminotransferase (ALT).

Conclusion
When HCV was found concomitantly with PV, a high possibility of severe disease pattern will be expected that entails special precautions in the treatment process.