BACKGROUND Necrolytic acral erythema(NAE) is a rare dermatological disorder,which is associated with hepatitis C virus(HCV) infection or zinc deficiency.It is characterized by erythematous or violaceous lesions occurr...BACKGROUND Necrolytic acral erythema(NAE) is a rare dermatological disorder,which is associated with hepatitis C virus(HCV) infection or zinc deficiency.It is characterized by erythematous or violaceous lesions occurring primarily in the lower extremities.The treatment includes systemic steroids and oral zinc supplementation.We report a case of NAE in a 66-year-old human immunodeficiency virus(HIV)/HCV co-infected woman with NAE.NAE is rarely reported in co-infected patients and the exact mechanisms of pathogenesis are still unclear.CASE SUMMARY A 66-year-old HIV/HCV co-infected female patient presented with painless,nonpruritic rash of extremities for one week and underwent extensive work-up for possible rheumatologic disorders including vasculitis and cryoglobulinemia.Punch skin biopsies of right and left thigh revealed thickened parakeratotic stratum corneum most consistent with NAE.Patient was started on prednisone and zinc supplementation with resolution of the lesions and improvement of rash.CONCLUSION Clinicians should maintain high clinical suspicion for early recognition of NAE in patients with rash and HCV.展开更多
BACKGROUNDWith the incidence of pancreatic diseases increasing year by year,pancreatichyperglycemia,as one of the common complications,is gradually gaining attentionfor its impact on the skin health of patients.CASE S...BACKGROUNDWith the incidence of pancreatic diseases increasing year by year,pancreatichyperglycemia,as one of the common complications,is gradually gaining attentionfor its impact on the skin health of patients.CASE SUMMARYThis was the case of an elderly female with clinical manifestations of necrolyticmigratory erythema,“three more and one less,”diabetes mellitus,hypertension,anemia,hypoproteinemia,and other syndromes,which had been misdiagnosedas eczema.Abdominal computed tomography showed a pancreatic caudal spaceoccupyinglesion,and the magnetic resonance scanning of the epigastric regionwith dynamic enhancement and diffusion-weighted imaging suggested a tumorof the pancreatic tail,which was considered to be a neuroendocrine tumor orcystadenoma.The patient was referred to a more equipped hospital for laparoscopicpancreatic tail resection.Post-surgery diagnosis revealed a neuroendocrinetumor in the tail of the pancreas.To date,the patient’s general condition is good,and she is still under close follow-up.CONCLUSIONNecrolytic migratory erythema can be induced by endocrine system tumors orendocrine metabolic abnormalities,with complex clinical manifestations,difficultdiagnosis,and easy misdiagnosis by dermatologists.The initial treatment principlesin dermatology include symptomatic supportive therapy and effectivedrugs to relieve skin lesions.After clarifying the etiology of glucagonoma,comprehensive treatment in collaboration with endocrinologists,generalsurgeons,and oncologists can help provide individualized treatment for patientsand improve their prognosis.展开更多
文摘BACKGROUND Necrolytic acral erythema(NAE) is a rare dermatological disorder,which is associated with hepatitis C virus(HCV) infection or zinc deficiency.It is characterized by erythematous or violaceous lesions occurring primarily in the lower extremities.The treatment includes systemic steroids and oral zinc supplementation.We report a case of NAE in a 66-year-old human immunodeficiency virus(HIV)/HCV co-infected woman with NAE.NAE is rarely reported in co-infected patients and the exact mechanisms of pathogenesis are still unclear.CASE SUMMARY A 66-year-old HIV/HCV co-infected female patient presented with painless,nonpruritic rash of extremities for one week and underwent extensive work-up for possible rheumatologic disorders including vasculitis and cryoglobulinemia.Punch skin biopsies of right and left thigh revealed thickened parakeratotic stratum corneum most consistent with NAE.Patient was started on prednisone and zinc supplementation with resolution of the lesions and improvement of rash.CONCLUSION Clinicians should maintain high clinical suspicion for early recognition of NAE in patients with rash and HCV.
文摘BACKGROUNDWith the incidence of pancreatic diseases increasing year by year,pancreatichyperglycemia,as one of the common complications,is gradually gaining attentionfor its impact on the skin health of patients.CASE SUMMARYThis was the case of an elderly female with clinical manifestations of necrolyticmigratory erythema,“three more and one less,”diabetes mellitus,hypertension,anemia,hypoproteinemia,and other syndromes,which had been misdiagnosedas eczema.Abdominal computed tomography showed a pancreatic caudal spaceoccupyinglesion,and the magnetic resonance scanning of the epigastric regionwith dynamic enhancement and diffusion-weighted imaging suggested a tumorof the pancreatic tail,which was considered to be a neuroendocrine tumor orcystadenoma.The patient was referred to a more equipped hospital for laparoscopicpancreatic tail resection.Post-surgery diagnosis revealed a neuroendocrinetumor in the tail of the pancreas.To date,the patient’s general condition is good,and she is still under close follow-up.CONCLUSIONNecrolytic migratory erythema can be induced by endocrine system tumors orendocrine metabolic abnormalities,with complex clinical manifestations,difficultdiagnosis,and easy misdiagnosis by dermatologists.The initial treatment principlesin dermatology include symptomatic supportive therapy and effectivedrugs to relieve skin lesions.After clarifying the etiology of glucagonoma,comprehensive treatment in collaboration with endocrinologists,generalsurgeons,and oncologists can help provide individualized treatment for patientsand improve their prognosis.
