NECROLYTIC ACRAL ERYTHEMA: A CUTANEOUS MARKER OE VIRAL HEPATITIS C

International Journal of Dermatology - Tập 35 Số 4 - Trang 252-256 - 1996
MOHAMED EL DAROUTI1, Mahmoud Abu El Ela1
1Department of Dermatology, Cairo University Faculty of Medicine, Cairo, Egypt.

Tóm tắt

Abstract Background. Necrolytic acral erythema (NAE) is a distinctive skin lesion that was found to affect the dorsa of the feet of seven patients having active viral hepatitis C. Necrolytic acral erythema occurs in the form of well circumscribed dusky erythematous areas that develop flaccid blisters in their early stages and a hyperkeratotic surface in their chronic form. Microscopically, lesions of NAE are similar to those of other necrolytic erythemas such as necrolytic migratory erythema, pellagra, and zinc deficiency. Method. Seven patients with NAE were included in this study. These patients underwent microscopic examination of punch biopsy specimens of the affected skin, abdominal sonography, ct scan of pancreas, and a liver biopsy. Blood samples were obtained for complete blood picture, serum glucose, zinc, amino acids, liver function tests, and markers of hepatitis. Results. All patients with nae were found to have hepatitis C by elisa and pcr. Conclusions. Necrolytic acral erythema is a distinctive type of necrolytic erythemas that was observed to occur almost exclusively with viral hepatitis C. Therefore, it should be considered an important cutaneous marker of hepatitis C, particularly in areas showing a high incidence of this form of hepatitis.

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Tài liệu tham khảo

Ackerman AB, 1978, Histologic diagnosis of inflammatory skin disease, 169

10.1111/j.1600-0560.1989.tb00590.x

10.1177/003591577106401212

10.1001/archderm.1942.01500120037004

10.1016/S0140-6736(74)91343-9

10.1111/j.1365-2133.1974.tb06406.x

10.1111/j.1365-2133.1967.tb11492.x

Ohyama K, 1982, Ultrastructural studies of necrolytic migratory erythema, Arch Dermatol, 118, 679, 10.1001/archderm.1982.01650210059020

10.1093/ajcn/39.3.351

10.1016/0002-9343(81)90858-5

10.7326/0003-4819-109-11-920

Kanekura T, 1991, Zinc deficiency: report of three cases, Cutis, 48, 161

Hendricks WM, 1991, Pellagra and pellagra‐like dermatitis: etiology, differential diagnosis, dermatopathology and treatment, Semin Dermatol, 10, 282

10.1111/j.1365-2133.1991.tb06044.x

Black MM, 1992, Textbook of dermatology, 2295

Proud VK, 1990, Fatty acid alterations and carboxylase deficiencies in the skin of biotin deficiency rats, Am J Clin Nutr, 51, 853, 10.1093/ajcn/51.5.853

Mock DM, 1991, Skin manifestations of biotin deficiency, Semin Dermatol, 10, 296

Sherertz E., 1986, Nutrition and the skin, 117

Doyle JA, 1979, Hyperglucagonaemia and necrolytic migratory erythema in cirrhosis—possible pseudoglucagonoma syndrome, Br J Dermatol, 100, 581

10.1016/S0190-9622(89)70144-4

10.7326/0003-4819-91-2-213

Iber EL, 1957, The plasma amino acids in patients with liver failure, J Lab Clin Med, 50, 417

10.1056/NEJM197401312900502

Mallinson CN, 1978, Treatment of malignant pacreatic glucagonoma: effect of zinc on the rash and hepatic arterial embolization on liver metastases, Gut, 19, A448

Schwartz RA, 1986, Erythrodema with fulminant hepatitis, Curtis, 37, 56

10.1016/0140-6736(90)93296-2

10.1016/0140-6736(90)92926-9

10.1016/0140-6736(91)91203-7

10.1016/0002-9343(91)90678-Q

10.1016/0140-6736(91)93443-D

Agnello V, A role of hepatitis C virus in type II cryoglobulinemia, New Engl J Med, 327, 1490, 10.1056/NEJM199211193272104

10.1001/archinte.142.1.101