Halpern Analisa V, Peikin Steven R, Ferzli Pascal, Heymann Warren R
Division of Dermatology, Department of Medicine, Cooper University Hospital-University of Medicine and Dentistry of New Jersey/Robert Wood Johnson Medical School, Camden, USA.
Cutis. 2009 Dec;84(6):301-4.
Hepatitis C virus (HCV) infection is the most common chronic blood-borne viral infection in the United States. Well-described cutaneous manifestations of HCV infection include polyarteritis nodosa, porphyria cutanea tarda, type II cryoglobulinemia-associated vasculitis, pruritus, erythema nodosum, urticaria and urticarial vasculitis, lichen planus, and erythema multiforme. First described in 1996, necrolytic acral erythema (NAE) is now recognized as a cutaneous acral eruption uniquely associated with HCV infection. Most patients present with chronic, acral, erythematous, and psoriasiform lesions. Acute presentations of NAE are rare and patients may present with atypical clinical features; in these cases, suspicion for HCV infection may be delayed for weeks to months until more classic chronic lesions develop. In many cases, NAE presents before the patient has been diagnosed with HCV infection, which allows dermatologists the unique opportunity to suspect and diagnose HCV infection based on skin findings alone.
丙型肝炎病毒（HCV）感染是美国最常见的慢性血源性病毒感染。HCV感染的皮肤表现包括结节性多动脉炎、迟发性皮肤卟啉病、II型冷球蛋白血症相关血管炎、瘙痒、结节性红斑、荨麻疹和荨麻疹性血管炎、扁平苔藓以及多形红斑。坏死性肢端红斑（NAE）于1996年首次被描述，现在被认为是一种与HCV感染独特相关的皮肤肢端皮疹。大多数患者表现为慢性、肢端、红斑性和银屑病样病变。NAE的急性表现很少见，患者可能表现出非典型临床特征；在这些情况下，对HCV感染的怀疑可能会延迟数周或数月，直到出现更典型的慢性病变。在许多情况下，NAE在患者被诊断出HCV感染之前就已出现，这使得皮肤科医生有独特的机会仅根据皮肤表现怀疑并诊断HCV感染。
