Acral Necrolytic Erythema: A Case Series

Authors

DOI:

https://doi.org/10.3126/njdvl.v24i1.77380

Keywords:

Necrolytic acral erythema, Zinc, Hepatitis

Abstract

It is currently accepted that necrotic acral erythema (NAE) represents a separate clinical entity, unlike earlier when it was a part of necrolytic migratory erythema. It manifests clinically as symmetrically distributed, well-defined, hyperpigmented papules and plaques with thick adherent scales over the dorsum of the feet. According to some theories, the underlying pathogenic mechanism of NAE is hepatic dysfunction leading to metabolic abnormalities such as hypoalbuminemia, hypoaminoacidemia, hyperglucagonemia, and transitory zinc insufficiency. To differentiate NAE from other necrolytic erythemas, a deeper comprehension of the etiopathogenesis and histological characteristics is necessary. Here, we report a case series of patients with necrolytic acral erythema & zinc deficiency, as evaluated, who showed significant improvement with oral zinc supplementation

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Author Biographies

Sreesha Cheekireddy, Department of Dermatology, Venereology & Leprosy, Chettinad Hospital and Research Institute, Kelambakkam, India

Junior Resident, Chettinad Health City, Kelambakkam, Tamil Nadu, India

Kavyadeepu RM, Department of Dermatology, Chettinad Hospital and Research Institute

Senior Resident, Department of Dermatology, Chettinad Hospital and Research Institute, Tamil Nadu, India

Mohnish Sekar, Karpaga Vinayaga Institute of Medical Science and Research Centre, India

Assistant Professor, Department of Dermatology, Karpaga Vinayaga Institute  of Medical Sciences & Research Center

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Published

2026-05-05

How to Cite

Cheekireddy, S., RM, K., & Sekar, M. (2026). Acral Necrolytic Erythema: A Case Series. Nepal Journal of Dermatology, Venereology & Leprology, 24(1), 50–53. https://doi.org/10.3126/njdvl.v24i1.77380

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Section

Case Reports