Extrahepatic manifestations of hepatitis include the following except -

Ans. is 'd' i.e., Palmo-plantar keratosis Extrahepatic manifestations of viral hepatitis* Immune complex-mediated tissue damage appears to play a pathogenetic role in the extrahepatic manifestations of acute hepatitis B.* The occasional prodromal serum sickness-like syndrome observed in acute hepatitis B appears to be related to the deposition in tissue blood vessel walls of HBsAg-anti-HBs circulating immune complexes, leading to activation of the complement system and depressed serum complement levels.* In patients with chronic hepatitis B, other types of immune- complex disease may be seen. Glomerulonephritis with the nephrotic syndrome is observed occasionally; HBsAg, immunoglobulin, and C3 deposition has been found in the glomerular basement membrane.* While generalized vasculitis (polyarteritis nodosa) develops in considerably fewer than 1% of patients with chronic HBV infection, 20-30% of patients with polyarteritisnodosa have HBsAg in serum.* Another extrahepatic manifestation of viral hepatitis is essential mixed cryoglobulinemia (EMC). The disorder is characterized clinically by arthritis; cutaneous vasculitis (palpable purpura); and, occasionally, with glomerulonephritis and serologically by the presence of circulating cryoprecipitable immune complexes of more than one immunoglobulin class.* Many patients with this syndrome have chronic liver disease and a substantial proportion has chronic HCV infection, with circulating immune complexes containing HCV RNA.* Immune-complex glomerulonephritis is another recognized extrahepatic manifestation of chronic hepatitis C.