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Necrolytic Acral Erythema: Current Insights.

Arun C Inamadar1, Ragunatha Shivanna2, Balachandra S Ankad3

  • 1Department of Dermatology, Venereology and Leprosy, Sri BM Patil Medical College, BLDE University, Vijayapura 586103, Karnataka, India.

Clinical, Cosmetic and Investigational Dermatology
|April 21, 2020
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Summary

Necrolytic acral erythema (NAE) is a distinct skin condition presenting on the feet, often linked to Hepatitis C virus (HCV). Oral zinc therapy shows effectiveness in treating NAE, regardless of HCV status.

Keywords:
NAEglucagonomahepatitisnecrolytic acral erythemazinc

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Area of Science:

  • Dermatology
  • Hepatology
  • Internal Medicine

Background:

  • Necrolytic acral erythema (NAE) is recognized as a distinct clinical entity.
  • NAE typically manifests as hyperpigmented, scaly lesions on the feet, often associated with Hepatitis C virus (HCV) infection.
  • Metabolic disturbances secondary to hepatic dysfunction, including hypoalbuminemia and zinc deficiency, are implicated in NAE pathogenesis.

Purpose of the Study:

  • To delineate the clinical and histopathological features of Necrolytic Acral Erythema (NAE).
  • To differentiate NAE from other necrolytic erythemas.
  • To evaluate the efficacy of oral zinc therapy in managing NAE.

Main Methods:

  • Clinical presentation and histopathological examination of NAE cases.
  • Differential diagnosis considerations including necrolytic migratory erythema (NME), acrodermatitis enteropathica (AE), and pellagra.
  • Assessment of treatment outcomes with oral zinc therapy.

Main Results:

  • NAE presents with characteristic well-demarcated, hyperpigmented, scaly plaques on the feet.
  • While often associated with HCV, NAE can occur in non-HCV patients.
  • Oral zinc therapy demonstrated significant efficacy in treating NAE across various patient groups.

Conclusions:

  • NAE is a distinct dermatosis requiring careful differentiation from other necrolytic erythemas.
  • Understanding the etiopathogenesis and histopathology aids in accurate diagnosis.
  • Oral zinc supplementation is a highly effective treatment for NAE.