Hepatitis B virus (HBV) is a common viral infection that has skin manifestations, which I encounter in my The Woodlands dermatology and Conroe dermatology offices. HBV is a double stranded DNA virus that is sexually transmitted and also spread through IV drug use as it is commonly found in the blood. The initial infection with HBV may result in flu like symptoms with fever, nausea/vomiting and fatigue. Patients may have right upper quadrant abdominal pain due to HBV causing hepatitis (liver inflammation) that may ultimately lead to liver cancer and liver failure. 30% of patients get a serum like sickness with the initial infection in which they have hives, joint pain, glomerulonephritis (kidney inflammation), and vasculitis (blood vessel inflammation). Polyarteritis nodosa is a very severe infection that can occur early in HBV infection or years later. It can produce vasculitis in large internal arteries as well as the smaller blood vessels in the skin resulting in multiple purpura (bruises). Fortunately, HBV has a very effective vaccine that is recommended for children as well as healthcare workers. Interferon has been used to treat HBV infection but HBV viremia can recur.
