ABSTRACT
Hepatitis C [HCV] is a plus strand RNA virus. The plus-strand RNA enters hepatocytes and produces minus-strand RNA that serves as a templates in virus proliferation. HCV infection can be associated with disorders of various organs other than the liver, including the skin. Necrolytic acral erythema [NAE] have been reported to occur in setting of chronic HCV infection which belongs to the family of necrolytic erythemas which characterized clinically by erythematous lesions that frequently develop blisters and microscopically by epidermal necrolytic changes involving mostly the upper part of the epidennis. The aim of this study was to examine HCV-infected patients for the presence of viral genome within the lesional cutaneous biopsy sample of NAE and to find the relationship between it and HCV infection. The study included 8 [5 males and 3 females] anti-HCV-positive patients with NAE. Reverse-transcriptase polymerase-chain reaction [RT-PCR] was performed to detect; HCVRNA plus strand in all sera samples and in peripheral blood mononuclear cells [PBMC] for certain cases and HCV-RNA plus and minus strands in cutaneous lesional biopsy samples of NAE. Although all patients were sero-positive for HCV antibodies, RT-PCR could only detect HCV genome in the sera of 5/8 patients [62.5%]. The HCV diagnosis in the 3 subjects who tested negative was established on the basis of detectable MCV genome in J'BMC. RT-PCR could not detect, the HCV-RNA plus strand in 6/8 [75%] of skin tissue biopsies and the HCV-RNA minus strand in all skin biopsies. Conclusion; the absence of MCV-RNA minus strand in tissue samples indicates that the skin lesion of NAE is not a site of HCV proliferation and that, HCV is not the primary cause of NAE per se. Further studies of lesional and non-lesional cutaneous biopsy specimen from HCV-infected patients with NAE are needed to evaluate the inter-relationship between HCV and NAE