Zinc-Responsive Necrolytic Acral Erythema in a Patient With Psoriasis: A Rare Case.
Necrolytic acral erythema (NAE) is a recently recognized dermatosis almost exclusively associated with hepatitis C virus (HCV) infection, and closely related to zinc deficiency. We present the case of a 60-year-old man with a history of psoriasis and chronic HCV infection, who developed new lesions of NAE extending from previous elephantine psoriatic plaques on bilateral lower legs. According to previous reports, resolution of NAE has been successfully achieved by treatment of the underlying HCV infection, or the use of oral zinc therapy. Our patient exhibited good response to zinc therapy. By reporting this case, we would like to raise the awareness of physicians to this unique acrally distributed dermatosis, which is distinct from psoriasis by its pathological feature of aggregated necrotic keratinocytes and its good response to zinc therapy rather than topical corticosteroids.
Taipei Veterans General Hospital, Taipei, Taiwan National Yang-Ming University, Taipei, Taiwan chenyiok@gmail.com.
Yi-Chun
YC
Hou
Taipei Veterans General Hospital, Taipei, Taiwan National Yang-Ming University, Taipei, Taiwan.
Chen-Yi
CY
Wu
D000284:Administration, Oral; D001706:Biopsy / Q000379:methods; D004890:Erythema; D005533:Foot Dermatoses / Q000097:blood / Q000209:etiology / Q000473:pathology / Q000628:therapy; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D011565:Psoriasis / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D012867:Skin / Q000473:pathology*; D014131:Trace Elements / Q000008:administration & dosage / Q000172:deficiency; D016896:Treatment Outcome; D015032:Zinc / Q000008:administration & dosage / Q000172:deficiency
D014131:Trace Elements; D015032:Zinc
hepatitis C virus; necrolytic acral erythema; psoriasis; zinc