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Arch Dermatol ; 136(6): 755-7, 2000 Jun.
Article in English | MEDLINE | ID: mdl-10871939

ABSTRACT

BACKGROUND: Necrolytic acral erythema is a recently described necrolytic erythema that is unique in its exclusive acral location and strong association with hepatitis C. OBSERVATION: We report the first case of necrolytic acral erythema in the United States. The patient is a 43-year-old black woman who presented with a 4-year history of tender, flaccid blisters localized to the dorsal aspect of her feet. Serum zinc and glucagon levels were normal. Serum antibodies were positive for hepatitis C, and a liver biopsy specimen showed chronic hepatitis. She was successfully treated with interferon alfa-2b and zinc. We review all previously reported cases. CONCLUSIONS: Necrolytic acral erythema is a distinct entity. In a review of the literature, most patients were between 35 and 55 years of age, although 1 patient was 12 years old. Five of 8 patients were female. Four of 7 patients described previously were treated with variable success using oral zinc sulfate and amino acids, whereas 2 were successfully treated with interferon alfa. All patients were infected with hepatitis C. Necrolytic acral erythema appears to be a skin disorder linked to infection with hepatitis C virus that responds to treatment with interferon alfa and oral zinc.


Subject(s)
Acrodermatitis/drug therapy , Foot Dermatoses/drug therapy , Hepatitis C, Chronic/drug therapy , Interferon-alpha/administration & dosage , Zinc Sulfate/administration & dosage , Acrodermatitis/diagnosis , Acrodermatitis/pathology , Administration, Oral , Adult , Biopsy , Diagnosis, Differential , Drug Therapy, Combination , Female , Foot Dermatoses/diagnosis , Foot Dermatoses/pathology , Hepatitis C, Chronic/diagnosis , Hepatitis C, Chronic/pathology , Humans , Injections, Subcutaneous , Interferon alpha-2 , Interferon-alpha/adverse effects , Necrosis , Recombinant Proteins , Skin/pathology , Zinc Sulfate/adverse effects
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