Necrolytic acral erythema

**Definition:** Necrolytic acral erythema is a distinctive acrally-located dermatosis affecting patients with active viral hepatitis C. It manifests principally on the dorsal surfaces of the feet and hands as well circumscribed dusky erythematous areas with flaccid blisters in its early stages and elevated scaly psoriasiform plaques in its chronic form. Microscopically there is keratinocyte necrosis in the upper epidermis.