Geria Aanand N, Holcomb Katherine Z, Scheinfeld Noah S
New Jersey Medical School, Newark, USA.
Cutis. 2009 Jun;83(6):309-14.
Necrolytic acral erythema (NAE) has been described as an early cutaneous marker for hepatitis C virus (HCV) infection. It most commonly presents as a well-defined, dusky, erythematous eruption with marked hyperkeratosis and a dark red rim associated with pruritus or burning. Necrolytic acral erythema bears microscopic and clinical resemblance to other necrolytic erythemas, including necrolytic migratory erythema (NME) and several nutrient-deficient syndromes. It is distinct, however, in its predominantly acral distribution and strong association with HCV infection. The pathogenesis is unknown, but a relationship to metabolic alterations has been hypothesized. Optimal therapy appears to be treatment of the underlying HCV infection using a combination of ribavirin and interferon alfa; oral zinc therapy may be an alternative but useful therapy. Cases of NAE without HCV infection suggest that more work needs to be done defining NAE and its relationship to HCV.
坏死松解性肢端红斑（NAE）已被描述为丙型肝炎病毒（HCV）感染的一种早期皮肤标志物。它最常见的表现是边界清晰、色泽暗沉的红斑疹，伴有明显的角化过度和暗红色边缘，伴有瘙痒或灼痛。坏死松解性肢端红斑在显微镜下和临床上与其他坏死松解性红斑相似，包括坏死松解性游走性红斑（NME）和几种营养缺乏综合征。然而，它的独特之处在于主要分布于肢端，且与HCV感染密切相关。其发病机制尚不清楚，但已推测与代谢改变有关。最佳治疗方法似乎是使用利巴韦林和干扰素α联合治疗潜在的HCV感染；口服锌治疗可能是一种替代但有用的疗法。无HCV感染的NAE病例表明，在定义NAE及其与HCV的关系方面还需要做更多的工作。
