A Study On Prevalence of The Elevated Transaminase(AST, ALT) and Hepatitis B, C Viral Markers in Dermatologic Patients

Kwon, Kyung Sool; Park, Jung Hum; Kim, Mun Bum; Oh, Chang Keun; Jang, Ho Sun

Abstract

BACKGROUND: Recently, in dermatologic area, the number of skin biopsy for diagnosis and treatment has been increased and the dermatosurgery which should give patients satisfaction developed widely. As the frequency of direct contact with patients increases, we must recognize and prevent infectious diseases such as hepatitis B and C. Also, because drugs which may affect function of liver were used in many medical clinics and shops, we have more chance of evaluating liver function before the treatment.
OBJECTIVE
We investigated the prevalence and associated diseases of the patients with elevated transaminase (AST,ALT), positive of hepatitis B surface antigen and anti-HCV Ab. And we tried to study the causes of elevated transaminase. METHOD: All the 1704 outpatients who visited the dermatologic clinic of Pusan National University Hospital from March 1996 to February 1999 were enrolled. AST and ALT level were assessed by kinetic method and elevated group comprised the subjects with AST and ALT levels exceeding the upper limit of normal for our laboratories (AST >40IU/L or ALT >37IU/L). HBsAg and anti-HCV Ab were tested by enzymeimmunoassay(EIA) and medical records were reviewed.
RESULTS
The prevalence of elevated transaminase was 13.6% and the peak age was the sixth decade. Most common associated disease categories were drug druption, eruption & urticaria. The prevalence of positive hepatitis B surface antigen was 9.7% and the peak age was the fourth decade (42.4%). Associated diseases of antigen positive patients were lichen planus, urticaria, cryoglobulinemia, etc. The prevalence of positive anti-HCV Ab was 3.4% and the sixth decade was the peak incidence of age distribution. The diseases such as urticaria, erythema nodosum, psoriasis, alopecia, and so on were investigated in the patients. Common suspected causes of elevated transaminase(AST, ALT) were hepatotoxic drug and viral hepatitis.
Conclusion
Increased hepatic parenchymal enzyme was investigated in a high percentage of studied patients. Also, the prevalence of HBV and HCV infection in dermatologic patients were relatively higher than that of reported normal Korean people. Therefore dermatologists should recognize these facts and be careful in dermatologic procedure.