Evaluation of zinc level in skin of patients with necrolytic acral erythema.
BACKGROUND
Necrolytic acral erythema (NAE) is considered a cutaneous sign of hepatitis C virus infection. Its exact pathogenesis is still not fully understood, with some reports about decreased serum zinc levels but none about its level in the skin.


OBJECTIVE
To assess skin (lesional and perilesional) and serum zinc levels in patients with NAE and compare them with levels in control subjects.


METHODS
Fifteen patients with NAE and 10 healthy controls were included in this study. Assessment of zinc level, in serum by graphite furnace atomic absorption spectrophotometry and in lesional and perilesional skin biopsies by flame atomic absorption spectrometry, was done in all subjects. Re-evaluation of serum and lesional skin zinc level was done after oral zinc treatment.


RESULTS
Mean±SD zinc levels were significantly lower in patients (serum 0·44 ± 0·13 mg L(-1) ; lesional skin 42·6 ± 18·9 mg L(-1) ; perilesional skin 32·5 ± 17·2 mg L(-1) ) than controls (serum 1·17 ± 0·29 mg L(-1) ; skin 100·1 ± 2·77 mg L(-1) ), with a positive correlation between lesional and perilesional skin zinc (r = 0·91, P < 0·01). Oral zinc supplementation significantly increased serum and skin zinc levels (by 159% and 4%, respectively; P < 0·05).


CONCLUSIONS
NAE is associated with decreased serum and skin zinc levels. Oral zinc supplementation corrects decreased levels of plasma and skin zinc much earlier than the desired clinical benefits appear.
Moneib
H A M
HA
Dermatology and Venereology Department, Ain Shams University, Cairo, Egypt.
Salem
S A M
SA
Darwish
M M
MM
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D001706:Biopsy; D019587:Dietary Supplements; D004890:Erythema / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology; D005260:Female; D005533:Foot Dermatoses / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000188:drug therapy / Q000473:pathology; D012867:Skin / Q000737:chemistry* / Q000378:metabolism / Q000473:pathology; D013054:Spectrophotometry, Atomic; D015032:Zinc / Q000032:analysis* / Q000097:blood / Q000627:therapeutic use
D015032:Zinc