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)