ABSTRACT
Hepatitis C virus (HCV) infection is the most common chronic blood-borne viral infection in the United States. Well-described cutaneous manifestations of HCV infection include polyarteritis nodosa, porphyria cutanea tarda, type II cryoglobulinemia-associated vasculitis, pruritus, erythema nodosum, urticaria and urticarial vasculitis, lichen planus, and erythema multiforme. First described in 1996, necrolytic acral erythema (NAE) is now recognized as a cutaneous acral eruption uniquely associated with HCV infection. Most patients present with chronic, acral, erythematous, and psoriasiform lesions. Acute presentations of NAE are rare and patients may present with atypical clinical features; in these cases, suspicion for HCV infection may be delayed for weeks to months until more classic chronic lesions develop. In many cases, NAE presents before the patient has been diagnosed with HCV infection, which allows dermatologists the unique opportunity to suspect and diagnose HCV infection based on skin findings alone.
Subject(s)
Erythema/diagnosis , Erythema/virology , Hepatitis C/complications , Hepatitis C/diagnosis , Necrosis/diagnosis , Necrosis/virology , Antiviral Agents/therapeutic use , Diagnosis, Differential , Drug Therapy, Combination , Erythema/drug therapy , Hepatitis C/drug therapy , Humans , Interferon-alpha/therapeutic use , Male , Middle Aged , Necrosis/drug therapy , Ribavirin/therapeutic use , Zinc Sulfate/therapeutic useABSTRACT
Patients with hereditary syndromes with renal tumors initially may present to the dermatologist. It is essential that dermatologists recognize these syndromes because the early diagnosis of renal cancer may prove to be lifesaving. The 4 hereditary syndromes with cutaneous manifestations are von Hippel-Lindau (VHL) syndrome, Birt-Hogg-Dube (BHD) syndrome, tuberous sclerosis (TS), and hereditary leiomyoma renal cell carcinoma (HLRCC) syndrome. This article reviews these disorders, emphasizing their cutaneous features and renal manifestations.
