Necrolytic acral erythema as a manifestation of Crohn’s disease and celiac disease - A report of two cases

Necrolytic acral erythema (NAE) is considered as a diagnostic marker of hepatitis C infection. Here, we report two cases of NAE in Crohn’s disease and celiac disease. Both the patients were seronegative for hepatitis C virus. The first case presented with recurrent diarrhea, weight loss, bullae on hyperpigmented plaque over extremities and gastrointestinal endoscopy and biopsy consistent with Crohn’s disease. The second case presented with recurrent diarrhea, vomiting, vesiculopustules and scaly plaques over extremities and duodenal biopsy diagnostic of celiac disease. NAE presents as papules and plaques with bullae over extremities, but tend to spare palms and soles. Our first patient had lesions on sole and the second patient had pustular lesions. To the best of our knowledge, there are no available reports of association of NAE with Crohn’s disease or celiac disease.