NECROLYTIC ACRAL ERYTHEMA

By Gary M. White, MD


Necrolytic acral erythema (NAE) is a distinctive skin disorder that is considered a cutaneous marker of HCV infection.

Clinical

It is characterized by well-circumscribed, dusky, erythematous to hyperpigmented plaques with variable scaling and erosion. Typical sites include the dorsum of the toes and feet. The plaques may extend proximally to the legs and may involve the back of the hands.

How common is NAE in the HCV population? In one study, 5/300 (1.7%) of chronic HCV-infected patients in Philadelphia, PA had NAE. All of the patients were African American men older than 40 years.

Some have postulated Necrolytic migratory eythema and necrolytic acral erythema are in a spectrum caused by the same process.

Workup

Treatment

Oral zinc should be given to normalize levels.

References

Pakistan Society of Teledermatology

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