Clinical and surgical therapeutic approach in Erithema Elevatum Diutinum - case report

Zacaron, Luciana Helena; Gonçalves, Júlia Costa de Faria; Curty, Vanessa Maria Amoreira; D'Ácri, Antônio Macedo; Lima, Ricardo Barbosa; Martins, Carlos José

doi:10.1590/abd1806-4841.20132150

Cited by 9 publications

(5 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Surgical excision of EED nodules has been reported, but we believe that it should be reserved for patients who fail medical management because of the excellent response rates to dapsone and second‐line corticosteroid treatment, or to those with only a few lesions . Patients with late, nodular EED are of special interest as surgical candidates as reported by LeBoit and Cockerell .…”

Section: Discussionmentioning

confidence: 96%

Erythema elevatum diutinum: a case report and review of literature

Doktor¹,

Hadi

Phelps

et al. 2018

Int J Dermatology

View full text Add to dashboard Cite

Erythema elevatum diutinum (EED) is a rare cutaneous leukocytoclastic vasculitis thought to be related to increased levels of circulating antibodies. It has been shown to be associated with HIV infection, tuberculosis, as well as various autoimmune diseases. A retrospective review of all cases of EED indexed in PubMed between 1990 and 2014 was performed. Inclusion criteria for articles was availability of full text in English and a biopsy-confirmed diagnosis of EED. All other articles were excluded. Cases were stratified by age and anatomic location of the lesions. Treatment response was coded as "complete," "partial," and "none." A total of 133 cases of EED with 381 lesions detailed in case reports and case series were included. Twenty-one cases were associated with HIV. Of 47 patients with reported paraproteinemias, IgA paraproteinemia was found in 57.45%, IgG paraproteinemia in 29.8%, IgM paraproteinemia in 10.6%, and IgD paraproteinemia in 2.1% of cases. Of 40 (30.1%) patients with reported comorbid autoimmune disease, rheumatoid arthritis was associated with 10 cases. Cancer was found to be associated with 9.77% of cases. Seventy-five patients were treated with dapsone, with 36 (48%) achieving complete treatment response, 24 (32%) achieving partial response, and seven (9.3%) achieving no response. Keeping the clinical associations of EED in mind, especially malignancy, is critical in management of the disease. More structured studies need to take place in order to fully define the mechanisms and strength of these associations.

show abstract

Section: Discussionmentioning

confidence: 96%

Erythema elevatum diutinum: a case report and review of literature

Doktor¹,

Hadi

Phelps

et al. 2018

Int J Dermatology

View full text Add to dashboard Cite

show abstract

“…The present case also highlights the importance of combining therapeutic methods to benefit the patient: dapsone (100 mg/d) to avoid the development of early lesions and surgical excision to treat late-stage lesions . Surgical excision is a treatment option that has been recently described with excellent results and, in the present case, was aimed to relieve discomfort for the patient and prevent interference with usual activities caused by the calcaneal nodules.…”

Section: Discussionmentioning

confidence: 99%

Cutaneous Nodules and Erythematous Plaques on the Extremities

2017

View full text Add to dashboard Cite

A healthy man in his 20s presented with a several-month history of asymptomatic, slightly erythematous cutaneous nodules, measuring 1.5 to 3.0 cm, over the calcanea (Figure , A). Physical examination revealed violaceous plaques, measuring 2 to 3 cm, on the extensor surface of the knees, bilaterally (Figure, B). Excisional biopsy specimens were obtained (Figure, C and D).Erythematous calcaneal nodules A Violaceous knee plaques B Calcaneal nodule specimen C Plaque specimen D Figure. A, Multiple asymptomatic erythematous nodules measuring 1.5 to 3.0 cm at presentation. B, Multiple violaceous plaques measuring 2 to 3 cm on the extensor surface of the knees. C, Excisional biopsy specimen of a calcaneal nodule (hematoxylin-eosin, original magnification ×20). D, Excisional biopsy specimen of a plaque (hematoxylin-eosin, original magnification ×20). WHAT IS YOUR DIAGNOSIS? A. Elastolytic granuloma B. Knee-located erythema elevatum diutinum (EED) with a calcaneal late-stage nodular component C. Epithelioid sarcoma D. Storiform collagenoma Clinical Review & Education JAMA Dermatology Clinicopathological Challenge

show abstract

“…1 - 4 It is presumed that the pathogenesis is related to deposition of immune complexes on vessel walls, activation of the complement cascade, neutrophil chemotaxis, excessive premature expression of proinflammatory cytokines, releasing lysozymes, collagenase, myeloperoxidase and hydrolases that induce deposition of fibrin inside and around the vessels. 3 , 5 , 6 , 7 It is clinically manifested by erythematous violaceous papules and nodules, isolated or confluent in plaques, of hardened consistency; at first they are soft, gradually becoming hardened and symmetrical, predominantly on the extensor surface of the extremities, mainly over the joints of hands, elbows, knees and ankles. Lesions have already been described on the trunk and retroauricular region.…”

Section: Discussionmentioning

confidence: 99%

“… 2 In these cases, the association of dapsone and surgical excision showed good results. 6 Other therapeutic options described in the literature include nicotinamide, tetracycline, colchicine, niacinamide, chloroquine and cyclosporine. 1 , 2 , 3 The use of cyclosporine in association with dapsone seems to have an additive or synergistic effect and may be an alternative for recalcitrant cases.…”

Section: Discussionmentioning

confidence: 99%

Erythema elevatum diutinum and hypothyroidism: coincidence or causal relationship?

Cirvidiu

Elias

Jorge

et al. 2015

An. Bras. Dermatol.

View full text Add to dashboard Cite

Erythema elevatum diutinum is a rare chronic leukocytoclastic vasculitis of unknown etiology. It is believed to be due to deposition of immune complexes in the vessels. Clinically it is manifested as erythematous violaceous papules and nodules, isolated or confluent with hardened consistency, symmetrical, usually located on the extensor surface of the extremities, particularly over the joints. Diagnosis is based on clinical and histological findings. We report the case of a woman, 71 years old, with erythematous violaceous nodules on the hands, elbows, back and legs, beginning two years ago, with pain and itching. Histopathological analysis revealed leukocytoclastic vasculitis, confirming the clinical suspicion. Laboratory tests revealed hypothyroidism. We report the case because of its rarity, with subsequent review of the literature.

show abstract

Clinical and surgical therapeutic approach in Erithema Elevatum Diutinum - case report

Cited by 9 publications

References 8 publications

Erythema elevatum diutinum: a case report and review of literature

Erythema elevatum diutinum: a case report and review of literature

Cutaneous Nodules and Erythematous Plaques on the Extremities

Erythema elevatum diutinum and hypothyroidism: coincidence or causal relationship?

Contact Info

Product

Resources

About