To the Editor.—
Castellano et al, in the October Archives (114:1530-1532, 1978), stated that "papular acrodermatitis associated with HBV [hepatitis B virus] infection has only been described in children." The authors failed to mention a report on papular acrodermatitis (PAC) occurring in three adults1 and mimicking the eruption first described by Gianotti in children. The three patients had circulating hepatitis B surface antigen (HBsAg). The eruption was followed by a benign icteric hepatitis that lasted from 30 to 45 days. In two cases, HBsAg disappeared in one month, and in one case, the antigen had been present for more than three months. Direct immunofluorescence staining exhibited C3 deposits in the vessel walls of the dermis without any deposition of immunoglobulins or fibrinogen. The HBsAg and hepatitis e antigen (HBeAg) could not be identified in the skin lesions by fluoresceinconjugated specific antiserum. Serum protein concentration of complement components Clq, C4, C3,
Claudy AL, Ortonne JP, Trepo C, Bugnon B. Papular Acrodermatitis Associated With Hepatitis B Virus Infection. Arch Dermatol. 1979;115(8):931. doi:10.1001/archderm.1979.04010080003005
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