Not to be confused with Palpable purpura.
| Erythema Anulare Centrifugum |
| Classification and external resources |
| ICD-10 |
L53.1 |
| ICD-9 |
695.0 |
| DiseasesDB |
29798 |
| eMedicine |
derm/131 |
| Patient UK |
Erythema annulare centrifugum |
Erythema anulare centrifugum (also known as "Deep gyrate erythema,"[1] "Erythema perstans,"[1] "Palpable migrating erythema",[1] and "Superficial gyrate erythema"[1]) is a descriptive term for a skin lesion.[1] The lesions form consists of redness (erythema) in a ring form (anulare) that spreads from the center (centrifugum). EAC was first described by Darier in 1916.[2][3][4] Many different terms have been used to classify these types of lesions and it is still controversial on what exactly defines EAC. Some of the types include (deep and superficial) annular erythema, erythema perstans, erythema gyratum perstans, erythema gyratum repens, darier erythema (Deep gyrate erythema & Deep gyrate erythema) and erythema figuratum perstans.
Contents
- 1 Symptoms
- 2 Diagnosis
- 3 Causes
- 4 Treatment
- 5 Alternative diagnosis
- 6 Interesting information
- 7 See also
- 8 References
- 9 External links
Symptoms
Occurring at any age these lesions appear as raised pink-red ring or bulls-eye marks. They range in size from 0.5–8 cm (0.20–3.15 in). The lesions sometimes increase size and spread over time and may not be complete rings but irregular shapes. Distribution is usually on the thighs and legs but can also appear on the upper extremities, areas not exposed to sunlight, trunk or face. Currently EAC is not known to be contagious, but as many cases are incorrectly diagnosed as EAC, it is difficult to be certain.
Diagnosis
There are no specific tests that can be performed to test for EAC; tests should be performed to rule out other possible diseases such as: pityriasis rosea, tinea corporis, psoriasis, nummular eczema, atopic dermatitis, drug reaction, erythema migrans and other rashes.
Causes
Often no specific cause for the eruptions is found. However, it is sometimes linked to underlying diseases and conditions such as:
- Food (including blue cheese or tomatoes).
- Contact Dermatitis (ie. cleaning agents, fabric softeners, etc)
- Fungal, Bacterial and Viral infections such as sinusitis, tuberculosis, candidiasis or tinea.
- Drugs including finasteride,[5] chloroquine, hydroxychloroquine, oestrogen, penicillin and amitriptyline.
- CANCER-sensitivity to malignancy (especially the type known as erythema gyratum perstans, in which there are concentric and whirling rings).
- Primary biliary cirrhosis.
- Graves disease.
- Appendicitis.
- Lupus[6]
- Pregnancy (EAC usually disappears/stops soon after delivery of baby).
- Hormone (Contraceptive Pill, Stress, Hormone Drugs)
- Lyme Disease
Treatment
No treatment is usually needed as they usually go away anywhere from months to years. The lesions may last from anywhere between 4 weeks to 34 years with an average duration of 11 months. If caused by an underlying disease or malignancy, then treating and removing the disease or malignancy will stop the lesions. It usually doesn't require treatment, but topical corticosteroids may be helpful[7] in reducing redness, swelling and itchiness.
Some supported and not supported methods of having an effect on EAC include:
- Photosensitive so it can be moved/reduced with appropriate sunlight.
- Vitamin D
- Immune system - hence it will increase in size/number when the immune system is low or overloaded.
- Hormone Drugs
- Disulone
- Topical calcipotriol - a topical vitamin D derivative has been known to be beneficial
Alternative diagnosis
- Sarcoidosis
- Fungal infection
- Lupus erythematosus
Interesting information
It is very rare and estimated to affect 1 in 100,000 per year.[citation needed] Because of its rarity the documentation, cases and information are sparse and not a huge amount is known for certain, meaning that EAC could actually be a set of many un-classified skin lesions. It is known to occur at all ages and all genders equally.[citation needed] Some articles state that women are more likely to be affected than men.[citation needed]
See also
- List of cutaneous conditions
References
- ^ a b c d e Rapini, Ronald P.; Bolognia, Jean L.; Jorizzo, Joseph L. (2007). Dermatology: 2-Volume Set. St. Louis: Mosby. ISBN 1-4160-2999-0.
- ^ synd/488 at Who Named It?
- ^ J. Darier. De l’érythème annulaire centrifuge (érythème papulo-circineé migrateuse et chronique) et de quelques éruptions analogues. Annales de dermatologie et de syphilographie, Paris, 1916-1917, 5: 57-58.
- ^ Bressler GS, Jones RE (May 1981). "Erythema annulare centrifugum". J. Am. Acad. Dermatol. 4 (5): 597–602. doi:10.1016/S0190-9622(81)70063-X. PMID 7240469.
- ^ Al Hammadi A, Asai Y, Patt ML, Sasseville D (April 2007). "Erythema annulare centrifugum secondary to treatment with finasteride". J Drugs Dermatol 6 (4): 460–3. PMID 17668547.
- ^ Weyers W, Diaz-Cascajo C, Weyers I (December 2003). "Erythema annulare centrifugum: results of a clinicopathologic study of 73 patients". Am J Dermatopathol 25 (6): 451–62. doi:10.1097/00000372-200312000-00001. PMID 14631185.
- ^ Enta T (November 1996). "Dermacase. Erythema annulare centrifugum". Can Fam Physician 42: 2148, 2151. PMC 2146938. PMID 8939316.
External links
- Derm Net NZ
- The Journal of Family Practice on EAC
- Erythema Annulare Centrifugum
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Urticaria and erythema (L50–L54, 695, 708)
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Urticaria
(acute/chronic) |
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Allergic urticaria
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- Urticarial allergic eruption
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Physical urticaria
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- Cold urticaria
- Primary cold contact urticaria
- Secondary cold contact urticaria
- Reflex cold urticaria
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- Heat urticaria
- Localized heat contact urticaria
- Solar urticaria
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- Dermatographic urticaria
- Vibratory angioedema
- Pressure urticaria
- Cholinergic urticaria
- Aquagenic urticaria
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Other urticaria
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- Acquired C1 esterase inhibitor deficiency
- Adrenergic urticaria
- Exercise urticaria
- Galvanic urticaria
- Schnitzler syndrome
- Urticaria-like follicular mucinosis
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Angioedema
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- Episodic angioedema with eosinophilia
- Hereditary angioedema
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| Erythema |
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Erythema multiforme/
drug eruption
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- Erythema multiforme minor
- Erythema multiforme major (Stevens–Johnson syndrome, Toxic epidermal necrolysis)
- panniculitis (Erythema nodosum)
- Acute generalized exanthematous pustulosis
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Figurate erythema
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- Erythema annulare centrifugum
- Erythema marginatum
- Erythema migrans
- Erythema gyratum repens
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Other erythema
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- Necrolytic migratory erythema
- Erythema toxicum
- Erythroderma
- Palmar erythema
- Generalized erythema
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| Description |
- Anatomy
- Physiology
- Development
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| Disease |
- Infections
- Vesiculobullous
- Dermatitis and eczema
- Papulosquamous
- Urticaria and erythema
- Radiation-related
- Pigmentation
- Mucinoses
- Keratosis, ulcer, atrophy, and necrobiosis
- Vasculitis
- Fat
- Congenital
- Tumors
- nevi and melanomas
- epidermis
- dermis
- Symptoms and signs
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| Treatment |
- Procedures
- Drugs
- antibiotics
- disinfectants
- emollients and protectives
- itch
- psoriasis
- other
- Wound and ulcer
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