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necrolytic acral erythema
Etiology:
- hepatitis C
Pathology:
- punch biopsy
- psoriasiform epidermal hyperplasia
- parakeratosis
- eosinophils
- papillary dermal inflammation
- intraepidermal necrosis
Clinical manifestations:
- hypertrophic verrucous plaques on dorsum of feet
- well-circumscribed, scaly plaques with cobblestone surfaces
Laboratory:
- hepatitis C virus RNA
Differential diagnosis:
- psoriasis
- eczematous dermatitis
- hypertrophic lichen planus
Management:
- treatment of hepatitis C
- oral zinc therapy +/-
- UV-B phototherapy
- topical tacrolimus
- topical glucocorticoids
Related
hepatitis C infection
hepatitis C virus
General
skin disease (dermatologic disorder, dermatopathy, dermatosis)
References
- Moffat GT, Ren Z, Simone AA.
An 18-Month History of Dorsal Foot Lesions.
JAMA. Published online January 15, 2021
PMID: 33449068
https://jamanetwork.com/journals/jama/fullarticle/2775460
- Abdallah MA, Ghozzi MY, Monib HA et al
Necrolytic acral erythema: a cutaneous sign of hepatitis C virus infection.
J Am Acad Dermatol. 2005 Aug;53(2):247-51
PMID: 16021118
- Raphael BA, Dorey-Stein ZL, Lott J et al
Low prevalence of necrolytic acral erythema in patients with chronic
hepatitis C virus infection.
J Am Acad Dermatol. 2012 Nov;67(5):962-8.
PMID: 22325461 Free PMC article.