Necrolytic Acral Erythema Differential Diagnoses

1. el Darouti M, Abu el Ela M. Necrolytic acral erythema: a cutaneous marker of viral hepatitis C. Int J Dermatol. 1996 Apr. 35(4):252-6. [QxMD MEDLINE Link].

2. Tabibian JH, Gerstenblith MR, Tedford RJ, Junkins-Hopkins JM, Abuav R. Necrolytic Acral Erythema as a Cutaneous Marker of Hepatitis C: Report of Two Cases and Review. Dig Dis Sci. 2010 May 26. [QxMD MEDLINE Link].

3. Abdallah MA, Ghozzi MY, Monib HA, et al. Necrolytic acral erythema: a cutaneous sign of hepatitis C virus infection. J Am Acad Dermatol. 2005 Aug. 53(2):247-51. [QxMD MEDLINE Link].

4. Frank C, Mohamed MK, Strickland GT, Lavanchy D, Arthur RR, Magder LS, et al. The role of parenteral antischistosomal therapy in the spread of hepatitis C virus in Egypt. Lancet. 2000 Mar 11. 355 (9207):887-91. [QxMD MEDLINE Link].

5. Wu YH, Tu ME, Lee CS, Lin YC. Necrolytic acral erythema without hepatitis C infection. J Cutan Pathol. 2009 Mar. 36(3):355-8. [QxMD MEDLINE Link].

6. Srisuwanwattana P, Vachiramon V. Necrolytic Acral Erythema in Seronegative Hepatitis C. Case Rep Dermatol. 2017 Jan-Apr. 9 (1):69-73. [QxMD MEDLINE Link].

7. Liu A, Erickson CP, Cockerell CJ, Hsu S. Necrolytic acral erythema: a case not associated with hepatitis C infection. Dermatol Online J. 2008 Jun 15. 14 (6):10. [QxMD MEDLINE Link].

8. Jakubovic BD, Zipursky JS, Wong N, McCall M, Jakubovic HR, Chien V. Zinc deficiency presenting with necrolytic acral erythema and coma. Am J Med. 2015 Aug. 128 (8):e3-4. [QxMD MEDLINE Link].

9. Ghosh A, Aggarwal I, De A, Samanta A, Chatterjee G, Bala S, et al. Zinc-responsive acral hyperkeratotic dermatosis-A novel entity or a subset of some well-known dermatosis?. Indian J Dermatol. 2015 Mar-Apr. 60 (2):136-41. [QxMD MEDLINE Link].

10. Garcovich S, Garcovich M, Capizzi R, Gasbarrini A, Zocco MA. Cutaneous manifestations of hepatitis C in the era of new antiviral agents. World J Hepatol. 2015 Nov 28. 7 (27):2740-8. [QxMD MEDLINE Link].

11. El-Darouti MA, Mashaly HM, El-Nabarawy E, et al. Leukocytoclastic vasculitis and necrolytic acral erythema in patients with hepatitis C infection: do viral load and viral genotype play a role?. J Am Acad Dermatol. 2010 Aug. 63(2):259-65. [QxMD MEDLINE Link].

12. Raphael BA, Dorey-Stein ZL, Lott J, Amorosa V, Lo Re V 3rd, Kovarik C. Low prevalence of necrolytic acral erythema in patients with chronic hepatitis C virus infection. J Am Acad Dermatol. 2012 Feb 9. [QxMD MEDLINE Link].

13. Woldow A, Manton JS, Campanelli C, Ringpfeil F. The necrolytic erythemas: a continuous spectrum?. Cutis. 2011 Oct. 88:185-8. [QxMD MEDLINE Link].

14. Panda S, Lahiri K. Seronegative necrolytic acral erythema: a distinct clinical subset?. Indian J Dermatol. 2010 Jul-Sep. 3:259-61. [QxMD MEDLINE Link].

15. Patel U, Loyd A, Patel R, Meehan S, Kundu R. Necrolytic acral erythema. Dermatol Online J. 2010 Nov. 11:15. [QxMD MEDLINE Link].

16. Ko HM, Hernandez-Prera JC, Zhu H, Dikman SH, Sidhu HK, Ward SC, et al. Morphologic features of extrahepatic manifestations of hepatitis C virus infection. Clin Dev Immunol. 2012:. 2012;:740138. [QxMD MEDLINE Link].

17. Nofal AA, Nofal E, Attwa E, El-Assar O, Assaf M. Necrolytic acral erythema: a variant of necrolytic migratory erythema or a distinct entity?. Int J Dermatol. 2005 Nov. 44(11):916-21. [QxMD MEDLINE Link].

18. Moneib HA, Salem SA, Darwish MM. Evaluation of zinc level in skin of patients with necrolytic acral erythema. Br J Dermatol. 2010 Sep. 163 (3):476-80. [QxMD MEDLINE Link].

19. Ogawa Y, Kawamura T, Shimada S. Zinc and skin biology. Arch Biochem Biophys. 2016 Dec 1. 611:113-119. [QxMD MEDLINE Link].

20. Pernet C, Guillot B, Araka O, Dereure O, Bessis D. Necrolytic acral erythema following hepatitis B vaccination. Br J Dermatol. 2014 Nov. 171(5):1255-6. [QxMD MEDLINE Link].

21. 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. J Gastroenterol Hepatol. 2006 Jul. 21(7):1200-6. [QxMD MEDLINE Link].

22. Yost JM, Boyd KP, Patel RR, Ramachandran S, Franks AG Jr. Necrolytic acral erythema. Dermatol Online J. 2013 Dec. 16;19(12):20709. [QxMD MEDLINE Link].

23. Williams J. Necrolytic acral erythema. DermAtlas. Available at http://dermatlas.med.jhmi.edu/derm/result.cfm?Diagnosis=178630456. Accessed: January 25, 2007.

24. Xiaoling Y, Hongzhong J, Tao Q. Image Gallery: Seronegative necrolytic acral erythema. Br J Dermatol. 2018 Aug. 179 (2):e88. [QxMD MEDLINE Link].

25. Pakistan Society of Teledermatology, Janjua S. Necrolytic acral erythema. Pakistan Society of Teledermatology. Available at http://paktelederm.blogspot.com/2012/12/how-would-you-treat-this-patient_23.html. Accessed: Feburary 8, 2013.

26. Abdallah MA, Ghozzi MY, Monib HA, et al. Histological study of necrolytic acral erythema. J Ark Med Soc. 2004 Apr. 100(10):354-5. [QxMD MEDLINE Link].

27. Hivnor CM, Yan AC, Junkins-Hopkins JM, Honig PJ. Necrolytic acral erythema: response to combination therapy with interferon and ribavirin. J Am Acad Dermatol. 2004 May. 50(5 Suppl):S121-4. [QxMD MEDLINE Link].

28. Iyengar S, Chang S, Ho B, Fung M, Konia TH, Prakash N, et al. Necrolytic acral erythema masquerading as cellulitis. Dermatol Online J. 2014 Nov 15. 20(11):[QxMD MEDLINE Link].

29. Najarian DJ, Lefkowitz I, Balfour E, Pappert AS, Rao BK. Zinc deficiency associated with necrolytic acral erythema. J Am Acad Dermatol. 2006 Nov. 55(5 Suppl):S108-10. [QxMD MEDLINE Link].

30. Najarian DJ, Najarian JS, Rao BK, Pappert AS. Hypozincemia and hyperzincuria associated with necrolytic acral erythema. Int J Dermatol. 2008 Jul. 47(7):709-11. [QxMD MEDLINE Link].

31. Bentley D, Andea A, Holzer A, Elewski B. Lack of classic histology should not prevent diagnosis of necrolytic acral erythema. J Am Acad Dermatol. 2009 Mar. 60(3):504-7. [QxMD MEDLINE Link]. [Full Text].

32. Hayat W, Zahra K, Mahmood LM, Ali Azfar N, Mohammed J. Necrolytic acral erythema: an unusual cutaneous presentation of hepatitis C virus infection. J Pakistan Asso Dermatol. 2012. 22:66-9.

33. Khanna VJ, Shieh S, Benjamin J, et al. Necrolytic acral erythema associated with hepatitis C: effective treatment with interferon alfa and zinc. Arch Dermatol. 2000 Jun. 136(6):755-7. [QxMD MEDLINE Link].

34. Wiznia LE, Laird ME, Franks AG Jr. Hepatitis C virus and its cutaneous manifestations: treatment in the direct-acting antiviral era. J Eur Acad Dermatol Venereol. 2017 Aug. 31 (8):1260-1270. [QxMD MEDLINE Link].

35. Abdallah MA, Hull C, Horn TD. Necrolytic acral erythema: a patient from the United States successfully treated with oral zinc. Arch Dermatol. 2005 Jan. 141(1):85-7. [QxMD MEDLINE Link].

36. de Carvalho Fantini B, Matsumoto FY, Arnone M, Sotto MN, Junior WB. Necrolytic acral erythema successfully treated with oral zinc. Int J Dermatol. 2008 Aug. 47(8):872-3. [QxMD MEDLINE Link].

37. Takagi H, Nagamine T, Abe T, Takayama H, Sato K, Otsuka T, et al. Zinc supplementation enhances the response to interferon therapy in patients with chronic hepatitis C. J Viral Hepat. 2001 Sep. 8 (5):367-71. [QxMD MEDLINE Link].

38. Manzur A, Siddiqui AH. Necrolytic acral erythema: successful treatment with topical tacrolimus ointment. Int J Dermatol. 2008 Oct. 47(10):1073-5. [QxMD MEDLINE Link].

Fnu Nutan, MD, FACP Assistant Professor, Department of Dermatology, Virginia Commonwealth University School of Medicine

Fnu Nutan, MD, FACP is a member of the following medical societies: American Academy of Dermatology, American College of Physicians, Indian Association of Dermatologists, Venereologists and Leprologists, Society of General Internal Medicine, Society of Hospital Medicine

Disclosure: Nothing to disclose.

Julie Zixuan Yi MD Candidate, Eastern Virginia Medical School

Julie Zixuan Yi is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

David F Butler, MD Former Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Association of Military Dermatologists, Phi Beta Kappa, Texas Dermatological Society

Disclosure: Nothing to disclose.

Camila K Janniger, MD Clinical Professor of Dermatology, Clinical Associate Professor of Pediatrics, Chief of Pediatric Dermatology, Rutgers New Jersey Medical School

Camila K Janniger, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Timothy McCalmont, MD Director, UCSF Dermatopathology Service, Professor of Clinical Pathology and Dermatology, Departments of Pathology and Dermatology, University of California at San Francisco; Editor-in-Chief, Journal of Cutaneous Pathology

Timothy McCalmont, MD is a member of the following medical societies: Alpha Omega Alpha, American Medical Association, American Society of Dermatopathology, California Medical Association, College of American Pathologists, United States and Canadian Academy of Pathology

Disclosure: Received consulting fee from Apsara for independent contractor.

Noah S Scheinfeld, JD, MD, FAAD † Assistant Clinical Professor, Department of Dermatology, Weil Cornell Medical College; Consulting Staff, Department of Dermatology, St Luke's Roosevelt Hospital Center, Beth Israel Medical Center, New York Eye and Ear Infirmary; Assistant Attending Dermatologist, New York Presbyterian Hospital; Assistant Attending Dermatologist, Lenox Hill Hospital, North Shore-LIJ Health System; Private Practice

Noah S Scheinfeld, JD, MD, FAAD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Katherine Z Holcomb, MD, MPH Dermatologist, Lupo Center for Aesthetic and General Dermatology; Clinical Assistant Professor, Department of Derrmatolgy, Tulane University School of Medicine

Katherine Z Holcomb, MD, MPH is a member of the following medical societies: American Academy of Dermatology, American Contact Dermatitis Society, American Society for Dermatologic Surgery, Louisiana Dermatological Society, Women's Dermatologic Society

Disclosure: Nothing to disclose.

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