Thick hyperkeratosis is sometimes present. Active lesions often include flaccid blisters. Edema may or may not be present. [emedicine.medscape.com]

Characteristic findings on physical examination Clinical appearance depends on the stage of NAE at presentation. [dermatologyadvisor.com]

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. [ncbi.nlm.nih.gov]

Patient 1 A 24-year-old male patient presented with a history of skin lesions on legs since three weeks. Skin lesions were associated with burning sensation. [idoj.in]

• Hodgkin Lymphoma

  lymphoma, sialadenitis, and sicca syndrome. [emedicine.medscape.com]

• Intravenous Drugs

  drug use, transfusion history, unprotected sexual intercourse) and perform appropriate laboratory testing as discussed above. [dermatologyadvisor.com]

• Relapsing Polychondritis

  polychondritis 733 219 Rhinophyma 737 220 Rocky Mountain spotted fever and other rickettsial infections 739 221 Rosacea 744 222 Sarcoidosis 752 223 Scabies 757 224 Scleredema 761 225 Scleroderma 764 226 Sebaceous hyperplasia 769 227 Seborrheic eczema [books.google.com]

• Overeating

  Many new contributors from all over the world provide you with fresh insights on all areas of gastroenterology and hepatology. Full-text online access via Expert Consult includes downloadable illustrations and links to reference abstracts. [books.google.de]

  Available from: Sir, A 20 year old male presented with dark colored, itchy, scaly lesions over extremities, buttocks and groin, on and off since 5 years. [ijdvl.com]

  On cutaneous examination, there were well demarcated, symmetrical, hyperpigmented, scaly plaques over dorsum of feet and hands, groin and perianal region [ Figure - 1 ] and [ Figure - 2 ]. Hair and nails were normal. [bioline.org.br]

  Background: We are reporting a series of interesting cases, which presented to us with psoriasiform lesions distributed over the acral regions of the body. [ingentaconnect.com]

  Complete resolution of eruption after four weeks of treatment Click here to view NAE is a rare condition, almost exclusively associated with hepatitis C infection. [1] It presents as a psoriasiform eruption mainly over the acral sites. [idoj.in]

• Asterixis

  Inquire and evaluate for the stigmata of liver disease such as jaundice, ascites, confusion, asterixis, gynecomastia, spider telangiectasias, renal dysfunction, varices, and excessive bleeding. [dermatologyadvisor.com]

• Pruritus Vulvae

  vulvae 688 208 Pseudofolliculitis barbae 691 209 Pseudoxanthoma elasticum 695 210 Psoriasis 697 211 Psychogenic excoriation 708 212 Pyoderma gangrenosum 711 213 Pyogenic granuloma 716 214 Radiation dermatitis 719 215 Raynaud disease and phenomenon 722 [books.google.com]

• Staphylococcus Aureus

  aureus and PantonValentine leukocidin Staphylococcus aureus infections 499 154 Miliaria 505 155 Molluscum contagiosum 508 156 Morphea 512 157 Mucoceles 515 158 Mucous membrane pemphigoid 517 eumycetoma and actinomycetoma 522 160 Mycobacterial atypical [books.google.com]

Significant updates on bariatric surgery, Barrett's esophagus, endoscopic ultrasound, endosonography, treatment of liver disease, and much more keep you current on the latest advances. [books.google.de]

Treatment Options Treatment options are summarized in Table I. Table I. [dermatologyadvisor.com]

Treatment of NAE includes supplementation of oral zinc. [idoj.in]

Medical Care The optimal treatment for necrolytic acral erythema (NAE) is the optimal treatment of hepatitis C—combination therapy with interferon and ribavirin. [slideshare.net]

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. [ncbi.nlm.nih.gov]

Prognosis With therapy, prognosis is fair. Some patients have a relapsing course. Necrolytic acral erythema (NAE) has no known directly associated morbidly or mortality. [emedicine.medscape.com]

Prognosis - Gianotti-Crosti syndrome The rash fades in 2-8 weeks with mild scaling. If hepatitis B is present, the liver takes between 6 months and 4 years to recover fully. Sometimes there is persistent hepatitis and long term viral carriage. [checkorphan.org]

However, NME presents as a hallmark clinical sign of glucagonoma syndrome. 2 Its early recognition allows for early diagnosis of the tumor and leads to a better prognosis. [dovepress.com]

HLA-DRB1, complement factors, and both antismooth muscle and antinuclear antibodies. 4 There have also been data to support a correlation between viral load and specific viral genotypes and NAE. 5 It is unclear if the presence of NAE relates to HCV prognosis [jddonline.com]

Etiology The cause of NAE is unknown, though the metabolic derangements from an HCV-infected liver are believed to play a role. [dermatologyadvisor.com]

[…] fingers, genetics, deficiency, cell differentiation, methods, analysis, pathology, drug therapy, zinc oxide, therapeutic use, schiff bases, metabolism, cytology, transcription factors, biosynthesis, saccharomyces cerevisiae proteins, copper, immunology, etiology [rails-staging2.nubic.northwestern.edu]

Etiology The cause of necrolytic acral erythema (NAE) is uncertain, but a metabolic alteration due to hepatocellular degeneration from hepatitis C infection is proposed. [emedicine.medscape.com]

Etiology and pathogenesis of necrolytic migratory erythema: review of the literature. MedGenMed. 2004;6(3):4. 8. Peterson LL, Shaw JC, Acott KM, Mueggler PA, Parker F. [dovepress.com]

Global epidemiology of hepatitis C virus infection. Lancet Infect Dis 2005;5:558-67. 14. El-Ghandour TM, Sakr MA, El-Sebai H, El-Gammal TF, El-Sayed MH. Necrolytic acral erythema in Egyptian patients with hepatitis C virus infection. [idoj.in]

Epidemiology Frequency United States Only two cases of necrolytic acral erythema (NAE) have been described in the United States to date, but the condition is likely more common than the case reports suggest. [emedicine.medscape.com]

Epidemiology, clinical features and diagnosis of gastroenteropancreatic endocrine tumours. Tomassetti P, Migliori M, Lalli S, Campana D, Tomassetti V, Corinaldesi R. Department of Internal Medicine and Gastroenterology, University ol Bologna, Italy. [thedoctorsdoctor.com]

Several theories have been proposed regarding the etiology and pathophysiology of NAE including hypoaminoacidemia, hyperglucagonemia, hypoalbuminemia, and low serum zinc levels. [dermatologyadvisor.com]

It has been speculated that viral load and viral genotype might play a role in NAE.6 Pathophysiology The pathophysiology of this condition is uncertain. [slideshare.net]

They are related to (1) chronic inflammation, (2) immune complex deposition, and (3) immunoproliferative diseases. [16] Pathophysiology The pathophysiology of necrolytic acral erythema (NAE) is uncertain. [emedicine.medscape.com]

The pathophysiology of NAE with respect to HCV is unclear. [jddonline.com]

The patient should be told to monitor for the stigmata of liver disease in order to prevent its progression. The patient’s skin must be monitored for secondary infection of skin lesions. [dermatologyadvisor.com]

[…] fever Causes - Gianotti-Crosti syndrome The specific viruses causing Gianotti-Crosti syndrome include: * Hepatitis B infection * Epstein Barr virus (the cause of glandular fever) * Enterovirus infections * Echo viruses * Respiratory syncytial virus Prevention [checkorphan.org]

Lack of classic histology should not prevent diagnosis of necrolytic acral erythema. J Am Acad Dermatol. 2009 Mar. 60(3):504-7. [Medline]. [Full Text]. Wiznia LE, Laird ME, Franks AG Jr. [emedicine.medscape.com]

Recognition of this condition is important as early intervention of undetected HCV infection with antivirals may decrease the morbidity and prevents the clinical outcomes such as chronic hepatitis, hepatic cirrhosis, and hepatocellular carcinoma. [idoj.in]