title: Leukocytoclastic vasculitis and necrolytic acral erythema in patients with hepatitis C infection: do viral load and viral genotype play a role?
abstract: BACKGROUND
  Leukocytoclastic vasculitis (LCV) and necrolytic acral erythema (NAE) are skin disorders associated with hepatitis C virus (HCV) infection. However, they have not been found to occur simultaneously in the same patient.
  
  
  OBJECTIVE
  We sought to analyze the role of serum HCV-RNA levels and HCV genotype in the pathogenesis of both LCV and NAE in an attempt to assess whether these two parameters play a role in mutual exclusivity of LCV and NAE in the same patient.
  
  
  METHODS
  The study included 11 patients with LCV and 13 with NAE, all of whom were infected with HCV. All 24 patients were evaluated for the quantitative levels of HCV-RNA, using real-time polymerase chain reaction. HCV genotyping was performed on 10 patients in each group (N = 20).
  
  
  RESULTS
  Patients with LCV had a higher prevalence of moderate and high levels of HCV-RNA viremia (P = .038) than those with NAE. However, there was no significant difference in HCV genotype between LCV and NAE groups (P = .211).
  
  
  CONCLUSIONS
  Small number of cases is a limitation.
  
  
  CONCLUSIONS
  Viral load seems to play a role in determining the response of the skin to HCV infection. High levels of HCV viremia were found to be significantly associated with LCV but not with NAE. HCV viremia may play a role in the development of LCV in HCV-infected patients.
authors.affiliation: Department of Dermatology, Faculty of Medicine, Cairo University, Cairo, Egypt. mohammad_eldarouti@yahoo.com
authors.forename: Mohammad A
authors.initials: MA
authors.lastname: El-Darouti
authors.forename: Heba M
authors.initials: HM
authors.lastname: Mashaly
authors.forename: Eman
authors.initials: E
authors.lastname: El-Nabarawy
authors.forename: Amal M
authors.initials: AM
authors.lastname: Eissa
authors.forename: Mona R E
authors.initials: MR
authors.lastname: Abdel-Halim
authors.forename: Marwa M T
authors.initials: MM
authors.lastname: Fawzi
authors.forename: Nermine H
authors.initials: NH
authors.lastname: El-Eishi
authors.forename: Sherine O
authors.initials: SO
authors.lastname: Tawfik
authors.forename: Naglaa S
authors.initials: NS
authors.lastname: Zaki
authors.forename: Anoud Z
authors.initials: AZ
authors.lastname: Zidan
authors.forename: Marwa
authors.initials: M
authors.lastname: Fawzi
authors.forename: Mohammad
authors.initials: M
authors.lastname: Abdelaziz
authors.forename: Mai M T
authors.initials: MM
authors.lastname: Fawzi
authors.forename: Olfat G
authors.initials: OG
authors.lastname: Shaker
mesh_terms: D000328:Adult; D004890:Erythema / Q000453:epidemiology* / Q000473:pathology / Q000821:virology*; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics* / Q000254:growth & development; D019698:Hepatitis C, Chronic / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D015995:Prevalence; D012367:RNA, Viral / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012867:Skin / Q000473:pathology; D020506:Untranslated Regions / Q000235:genetics; D018366:Vasculitis, Leukocytoclastic, Cutaneous / Q000453:epidemiology* / Q000473:pathology / Q000821:virology*; D019562:Viral Load; D014766:Viremia / Q000453:epidemiology; D055815:Young Adult
chemical_list: D012367:RNA, Viral; D020506:Untranslated Regions