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Necrolytic acral erythema masquerading as cellulitis
Sanjana Iyengar1, Shurong Chang, Baran Ho
1Florida State College of Medicine.
Dermatology Online Journal
|November 25, 2014
Summary
Necrolytic acral erythema (NAE), a rare skin condition, is linked to hepatitis C virus (HCV) and zinc deficiency. Early diagnosis of NAE is crucial for effective treatment and preventing complications.
Area of Science:
- Dermatology
- Hepatology
- Nutritional Science
Background:
- Necrolytic acral erythema (NAE) is a rare dermatosis often associated with hepatitis C virus (HCV) infection.
- NAE is characterized by specific skin lesions on the extremities and has been recently linked to zinc deficiency.
Observation:
- A patient presented with a 9-month history of progressive bilateral lower extremity erythema, swelling, erosions, and nail dystrophy.
- Symptoms were unresponsive to multiple courses of antibiotics for presumed cellulitis.
Findings:
- Serum studies confirmed significant zinc deficiency in the patient.
- Histopathology revealed psoriasiform epidermal hyperplasia, consistent with NAE.
Implications:
- This case reinforces the association between NAE, HCV infection, and zinc deficiency.
- Highlights diagnostic challenges and the importance of evaluating for underlying HCV and zinc deficiency in suspected NAE cases to ensure timely and appropriate management.
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