Kim JW, Park SY, Kim NI, Choi SK, Yoon JH. Mucocutaneous manifestation mimicking vasculitis in chronic hepatitis B: A case report. World J Clin Cases 2025; 13(29): 109516 [DOI: 10.12998/wjcc.v13.i29.109516]
Corresponding Author of This Article
Jae Hyun Yoon, MD, PhD, Department of Gastroenterology and Hepatology, Chonnam National University Hospital and Medical School, Je-bong ro 42, Dong Gu, Gwangju 61469, South Korea. zenmake14@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Oct 16, 2025; 13(29): 109516 Published online Oct 16, 2025. doi: 10.12998/wjcc.v13.i29.109516
Mucocutaneous manifestation mimicking vasculitis in chronic hepatitis B: A case report
Jin Won Kim, Shin Young Park, Nah Ihm Kim, Sung Kyu Choi, Jae Hyun Yoon
Jin Won Kim, Shin Young Park, Sung Kyu Choi, Jae Hyun Yoon, Department of Gastroenterology and Hepatology, Chonnam National University Hospital and Medical School, Gwangju 61469, South Korea
Nah Ihm Kim, Department of Pathology, Chonnam National University Hospital, Gwangju 61469, South Korea
Author contributions: Yoon JH contributed to conceptualization, data curation, funding acquisition, project administration, resources, visualization; Park SY contributed to data curation, investigation, writing – original draft; Choi SK contributed to project administration, visualization; Kim NI contributed to resources; Kim JW contributed to writing – original draft, writing – review & editing.
Supported by Chonnam National University Hospital Biomedical Research Institute, No. BCRE23215.
Informed consent statement: Written informed consent was obtained from the patient for publication of this case report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jae Hyun Yoon, MD, PhD, Department of Gastroenterology and Hepatology, Chonnam National University Hospital and Medical School, Je-bong ro 42, Dong Gu, Gwangju 61469, South Korea. zenmake14@gmail.com
Received: May 19, 2025 Revised: June 11, 2025 Accepted: July 22, 2025 Published online: October 16, 2025 Processing time: 104 Days and 3 Hours
Abstract
BACKGROUND
Hepatitis B virus (HBV) primarily causes hepatic inflammation and has various clinical manifestations. However, extrahepatic reactions, ranging from localized or systemic inflammation, may occur in some cases. Here, we report a case of an acute exacerbation of chronic HBV infection with atypical extrahepatic manifestation confined to the skin and mucosa despite nucleotide analog treatment, which was fully recovered on systemic steroid treatment.
CASE SUMMARY
A 53-year-old woman visited a clinic due to worsening skin rash and mucosal inflammation. She was receiving antiviral therapy due to a recent acute exacerbation of chronic HBV infection. While liver function was improving with antiviral treatment, skin rash and mucosal inflammatory lesions gradually worsened. Thus, blood tests and skin biopsy were performed to determine the cause. Despite a thorough review of serum markers and skin biopsy results, a concrete diagnosis revealing other etiology apart from the acute phase of HBV infection could not be established. The cutaneous lesions were considered a rare immunologic extrahepatic manifestation of HBV, warranting systemic steroid treatment. Afterward, both skin and mucosal lesions rapidly improved, and the patient was discharged without any sequelae.
CONCLUSION
Clinicians should recognize mucocutaneous manifestations of chronic HBV, as systemic steroids may yield favorable outcomes.
Core Tip: Our case report highlight that extrahepatic manifestations affecting the skin and mucosa can occur in chronic hepatitis B patients, even during nucleotide analogue treatment, and may be effectively managed with systemic steroids, likely targeting immune complex-mediated inflammation.
