The Journal of the Association of Physicians of Tamil Nadu Issue 1
Niacin/Zinc Deficiency Presented as Necrotising Acral Dermatitis in Decompensated Liver Disease Patient



The journal is published as a quarterly issue.
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HISTORY
Available Online: April 2020
ABSTRACT
We hereby describe a case of a 65-year-old male who has treated for DCLD, came with bilateral symmetrical lesions (blebs with rupturing) on both lower limbs and foot. Investigations revealed low niacin and zinc levels and histopathology revealed hyperkeratosis, parakeratosis, acanthosis and perivascular mononuclear cell infiltrate. A diagnosis of pellagra with concomitant zinc deficiency with Necrolytic acral dermatitis was done for our patient. Necrolytic acral dermatitis is thought to be a reliable diagnostic marker of Hepatitis C infection(1). He was found to be seronegative for HCV infection,the patient showed a dramatic response to Niacin and Zinc therapy. Very few cases of seronegative Necrolytic acral dermatitis associated with micronutrient deficiency have been reported, which prompted the present report(2)
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© 2020 Dr. Vijay Viswanathan, published by Association of Physicians of India-Tamilnadu State Chapter