Abstract:
Necrolytic acral erythema (NAE) is a newly described entity, seen in patients infected with hepatitis C virus.
It is characterized by its distinguishing acral distribution, psoriasiform skin eruption and histological features.
Its etiopathogenesis is not fully understood though hypo amino academia, hyperglucagonemia and zinc
deficiency are considered as probable causes. In 1996, El Darouti and Abu el Ela first described this entity in
seven Egyptian patients with hepatitis C virus (HCV). Since then, several small studies and cases have been
reported around the world. Nevertheless, it may occur independently without HCV association as a few
cases have been reported recently. We report two seronegative cases of NAE, which responded dramatically
with oral zinc therapy. This suggests that NAE could be an isolated clinical subset.
