1/18. Necrolytic acral erythema associated with hepatitis c: effective treatment with interferon alfa and zinc.BACKGROUND: Necrolytic acral erythema is a recently described necrolytic erythema that is unique in its exclusive acral location and strong association with hepatitis c. observation: We report the first case of necrolytic acral erythema in the united states. The patient is a 43-year-old black woman who presented with a 4-year history of tender, flaccid blisters localized to the dorsal aspect of her feet. serum zinc and glucagon levels were normal. serum antibodies were positive for hepatitis c, and a liver biopsy specimen showed chronic hepatitis. She was successfully treated with interferon alfa-2b and zinc. We review all previously reported cases. CONCLUSIONS: Necrolytic acral erythema is a distinct entity. In a review of the literature, most patients were between 35 and 55 years of age, although 1 patient was 12 years old. Five of 8 patients were female. Four of 7 patients described previously were treated with variable success using oral zinc sulfate and amino acids, whereas 2 were successfully treated with interferon alfa. All patients were infected with hepatitis c. Necrolytic acral erythema appears to be a skin disorder linked to infection with hepatitis c virus that responds to treatment with interferon alfa and oral zinc.- - - - - - - - - - ranking = 1keywords = hepatitis (Clic here for more details about this article) |
2/18. Histopathologic features seen in Gianotti-Crosti syndrome secondary to Epstein-Barr virus.BACKGROUND: Gianotti-Crosti syndrome (GCS) or infantile papular acrodermatitis presents as a symmetric erythematous lichenoid papular and papulovesicular eruption of the face, extremities, and buttocks, usually occurring in young children. GCS has been associated with hepatitis B and enteroviruses, as well as Epstein-Barr virus (EBV) and, rarely, cytomegalovirus. OBJECTIVE: The purpose of this study was to use immunohistochemical studies to determine the pattern of the lymphoid infiltrate and evidence for viral antigens in cases of EBV-associated GCS. methods: Routine histologic and immunohistochemical stains were evaluated in 3 patients with typical GCS. All 3 patients showed serologic evidence of an acute EBV infection. The immunohistochemical studies included monoclonal antibodies for CD3, CD4, CD8, CD20, TIA, S-100 protein, KP-1, EBV latent membrane antigen-1, and EBV-encoded nuclear antigen-2. RESULTS: All biopsy specimens showed minimal epidermal spongiosis with marked papillary dermal edema. The associated inflammatory infiltrate showed a mixed mononuclear cell infiltrate with rare eosinophils. Immunohistochemical stains for latent membrane antigen-1 and EBV-encoded nuclear antigen-2 were negative for EBV. The majority of mononuclear cells showed membrane staining for CD3, 30% to 40% of the CD3 mononuclear cells showed positive staining for CD4, and 50% to 60% showed positive staining with CD8. TIA( ) cells appeared to correspond to the CD8( ) cells. CONCLUSION: Although papillary dermal edema has been reported within the spectrum of histologic findings in GCS, it was marked and a consistent finding in the 3 cases in which EBV was the most likely etiologic agent. The presence of large numbers of cytotoxic T cells in the inflammatory infiltrate may have accentuated this histologic finding and may be a relatively distinctive histologic finding with GCS associated with EBV.- - - - - - - - - - ranking = 0.11111111111111keywords = hepatitis (Clic here for more details about this article) |
3/18. Papular acrodermatitis of childhood: the Gianotti-Crosti syndrome.Papular acrodermatitis of childhood (PAC), also known as Gianotti-Crosti syndrome, is a self-limited disorder with acute onset generalized lymphadenopathy and monomorphic lentil-sized, dense, nonconfluent, symmetric, flat-topped, non-pruritic papules. We describe 2 patients, one with anicteric hepatitis, lymphocytosis, and positive hepatitis B surface antigenemia, and the other with a cytomegalovirus (CMV) infection.- - - - - - - - - - ranking = 0.22222222222222keywords = hepatitis (Clic here for more details about this article) |
4/18. Combined vaccination by measles and hepatitis b vaccines: a new cause of Gianotti-Crosti syndrome.An 11-month-old boy presented with Gianotti-Crosti syndrome. He had received measles and a third dose of hepatitis b vaccines 2 weeks before the onset of the eruption. There were no clinical symptoms of any viral infection at the presentation. Serological tests for common viral infections were negative. The combination of measles and hepatitis b vaccines was likely the relevant factor in the etiology.- - - - - - - - - - ranking = 0.66666666666667keywords = hepatitis (Clic here for more details about this article) |
5/18. Necrolytic acral erythema: response to combination therapy with interferon and ribavirin.Necrolytic acral erythema is a papulosquamous and sometimes vesiculobullous eruption bearing clinical and histologic similarity to other necrolytic erythemas such as necrolytic migratory erythema, pseudoglucagonoma, and nutritional deficiency syndromes. Necrolytic acral erythema is distinguished by its association with hepatitis c infection and its predominantly acral distribution. We describe a pediatric patient with necrolytic acral erythema whose eruption resolved with hyperalimentation and combination interferon and ribavirin therapy, despite the persistence of detectable viral load and continued hepatic and renal insufficiency.- - - - - - - - - - ranking = 0.11111111111111keywords = hepatitis (Clic here for more details about this article) |
6/18. Gianotti-Crosti syndrome caused by acute hepatitis b virus genotype D infection.A 12-year-old girl with Gianotti-Crosti syndrome caused by hepatitis b virus (HBV) infection was admitted due to eruption on her extremities. Laboratory findings revealed elevation of transaminase, positivity for HB surface antigen (HBsAg), and an IgM type anti-HB core. The eruption and level of transaminase improved, and HBsAg became negative within 2 months of onset. Analysis of the virus revealed it to be genotype D with a genomic length of 3,182 bases and the HBsAg serotype was ayw3, which is very rare in japan. The possible relationship between Gianotti-Crosti syndrome and HBV genotype D infection is discussed.- - - - - - - - - - ranking = 0.55555555555556keywords = hepatitis (Clic here for more details about this article) |
7/18. Necrolytic acral erythema: a patient from the united states successfully treated with oral zinc.BACKGROUND: Recently, necrolytic acral erythema (NAE) has been described as a cutaneous marker for hepatitis c virus (HCV) infection. Only 2 cases have been reported in the united states. Successful remission has been induced only with interferon therapy with or without ribavirin. OBSERVATIONS: We describe a 46-year-old, HCV-positive African American woman with well-defined, dusky, erythematous plaques on the dorsa of the feet, Achilles tendons, legs, knees, and elbows. Histologic examination revealed confluent upper epidermal necrosis, acanthosis, papillomatosis, and superficial and deep perivascular inflammation. She was diagnosed as having NAE. We induced successful disease remission with oral zinc administration. This is the third NAE case reported in the united states and the first report of disease remission with oral zinc therapy alone. CONCLUSIONS: Since its initial description in egypt, more cases of NAE are being reported in the united states. Increased awareness of this entity is crucial. Oral zinc might represent a less toxic alternative therapeutic option for patients with NAE.- - - - - - - - - - ranking = 0.11111111111111keywords = hepatitis (Clic here for more details about this article) |
8/18. Papular acrodermatitis of childhood (Gianotti-Crosti disease).An 11-year-old boy had lentil-sized lichenoid papules, localized to the limbs and trunk, together with acute, nonicteric, hepatitis B surface antigen-positive hepatitis. The clinical picture and course were typical of Gianotti-Crosti disease. Monoclonal antibodies were used to study the lymphocyte subpopulations and surface antigens in the inflammatory infiltrate in frozen sections of a skin biopsy specimen. The results provide data on the pathogenic mechanism of the papular exanthem.- - - - - - - - - - ranking = 0.22222222222222keywords = hepatitis (Clic here for more details about this article) |
9/18. Transient lymphoblastosis and thrombocytopenia in Gianotti-Crosti syndrome.Gianotti-Crosti syndrome, or papular acrodermatitis of childhood, represents a characteristic rash that is irregularly associated with hepatitis B infection. The authors report papular acrodermatitis in a 10-month-old child with leukopenia, thrombocytopenia, circulating lymphoblasts, and acute anicteric hepatitis B. physical examination revealed a densely distributed papular rash on the patient's extremities and face and neck, but not on his trunk, buttocks, palms, or soles. Laboratory investigation revealed a normal bone marrow and positive hepatitis B serology. This case reinforces the fact that hematologic findings should not dissuade the work-up of papular acrodermatitis for hepatitis B or other less commonly associated viruses.- - - - - - - - - - ranking = 0.44444444444444keywords = hepatitis (Clic here for more details about this article) |
10/18. Gianotti-Crosti syndrome associated with Epstein-Barr virus infection.Gianotti-Crosti syndrome, a distinctive eruption occurring after hepatitis B infection, is characterized by symmetric, nonpruritic lichenoid papules usually localized to the face, limbs, and buttocks. In north america, hepatitis B antigenemia is rarely associated with Gianotti-Crosti syndrome in infants. Recent reports indicate there are a variety of infectious agents associated with Gianotti-Crosti syndrome. We report a case of an 11-month-old white female infant with Gianotti-Crosti syndrome and concurrent primary Epstein-Barr virus infection without evidence of hepatitis B infection.- - - - - - - - - - ranking = 0.33333333333333keywords = hepatitis (Clic here for more details about this article) |
| | Next -> |