Necrolytic acral erythema: a rare entity

Necrolytic acral erythema [NAE] is a rare but distinct clinical entity. It is one of the necrolytic erythemas that presents with itchy well-defined, dusky, erythematous to violaceous papules and plaques on acral areas

We report a case of a 50-year-old woman with 8-year history of itchy hyperpigmented papules and plaques on dorsum of both feet. Later, she developed similar lesions on both hands along with hemorrhagic blisters and purpura

She was found to be a hepatitis C virus [HCV] positive case. Histopathological findings were consistent with necrolytic acral erythema. She was treated with topical tacrolimus, oral zinc and cetirizine, and referred to medical outpatient department for treatment of HCV infection i.e. interferon and ribavirin