Evaluation of Hyperzincuria in Patients with Necrolytic Acral Erythema

Abstract

Necrolyticacral erythema (NAE) was first described in 1996 by El-Darouti and Abou El Ela, it was presented as a cutaneous marker for hepatitis C virus infection.Several pathogenic mechanisms for NAE were postulated. NAE appears to be an immunemediated response in chronic HCV patients, associated with, lower C3 and C4 (complements C3 and C4). Another postulated theory is low serum zinc levels. Hypozincemia and hyperzincuria have been seen in patients with chronic liver diseases due to impairment of protein metabolism which affects the plasma transport of zinc. This study was toevaluate urinary zinc level in patients with necrolyticacral erythema.The mean serum zinc for all patients was lower than the normal reference range and also was lower than that of both HCV-infected control patients group and healthy control group.As regards urinary zinc,its level was in the normal reference range although higher than that of both HCV-infected control patients group and healthy control group but this was not statistically significant.Further studies on the pathogenic mechanisms of the development of NAE was recommended.