Erythema annulare centrifugum: Deep variant with vasculitis like histopathology

Nayak, Sangeeta Umesh; Shenoi, Shrutakirthi D; Prabhu, Smitha

doi:10.4103/0019-5154.114007

Cited by 8 publications

(11 citation statements)

References 2 publications

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“…However, only the latter is characterized by migratory and fleeting lesions, while the others are conspicuous by the presence of lesions that last for months to years. 10 ECM was discarded due to negative serology for B. burgdorferi. Polymorphous light eruption also was also excluded because the lesions developed in non-photo-exposed areas.…”

Section: Discussionmentioning

confidence: 99%

Possibly drug-induced palpable migratory arciform erythema

Dantas

Valente

Veronez

et al. 2015

An. Bras. Dermatol.

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Palpable migratory arciform erythema is an entity of unknown etiology, with few published cases in the literature. The clinical and histopathological features of this disease are difficult to be distinguished from those of Jessner’s lymphocytic infiltration of the skin, lupus erythematous tumidus and the deep erythema annulare centrifugum. We describe here the first two Brazilian cases of palpable migratory arciform erythema. The patients presented with infiltrated annular plaques and erythematous arcs without scales. These showed centrifugal growth before disappearing without scarring or residual lesions after a few days. They had a chronic course with repeated episodes for years. In addition, these cases provide evidence of a drug-induced etiology.

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Section: Discussionmentioning

confidence: 99%

Possibly drug-induced palpable migratory arciform erythema

Dantas

Valente

Veronez

et al. 2015

An. Bras. Dermatol.

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“…Indeed, EAC consistently begins as a small, firm papule slowly expanding into annular, polycyclic lesions with central clearing. As the lesions extend centrifugally, the innermost area flattens and fades [1][2][3][4]6]. The underlying etiologies can rarely be established and EAC generally runs a chronic and recurrent course without evidence of significant response to treatment [1,2].…”

Section: Discussionmentioning

confidence: 99%

Deep variant of Erythema Annulare Centrifugum

Yorulmaz¹,

Artüz²,

D³

2014

Our Dermatol Online

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A 29-year-old woman came to our outpatient clinic with a several-month history of itchy red lesions over her trunk. There was no family history and past history of any other diseases or medication. Dermatological examination revealed annular and oval-shaped plaques up to several cm's in size, one of which was polycyclic in configuration, on back of the patient (Fig. 1). It was also noticed that lesions had erythematous indurated bordes with paler central areas (Fig. 1). In addition there was an erythematous, firm, solitary papule with prominent pallor on the centrum of one of the large plaques which was situated on the right posterior thoracic area (Fig. 2). A lesional skin biopsy demonstrated superficial and deep perivascular 'sleeve-like' lymphohistiocytic infiltrate (Figs 3, 4). Laboratory investigations including complete blood count and differential, erythrocyte sedimentation rate, serum chemistry profile, urinalysis, thyroid panel, chest X-ray, antinuclear antibodies, antibodies against borrelia, cultures for fungi, purified protein derivative test, screening for anti-HIV were within normal limits and malignancy workup was negative. Centrifugum. Our Dermatol Online. 2014; 5(4): 426-427. 426 © Our Dermatol Online 4.2014 DEEP VARIANT OF ERYTHEMA ANNULARE CENTRIFUGUM

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“…Furthermore, the superficial variant is characterized by epidermal changes such as focal spongiosis, focal parakeratosis, and epidermal hyperplasia. 3 EAC is thought to be a hypersensitivity reaction to unknown stimuli, including infections, tumours, blood dyscrasias, dysproteinemias, immunologic disorders, or drug intake. 3 4,5 These 2 previous cases received PEG-IFNα-2a, whereas our patient received PEG-IFNα-2b; therefore, it appears that EAC has now been associated with either the α-2a or α-2b types of pegylated interferons.…”

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“…3 EAC is thought to be a hypersensitivity reaction to unknown stimuli, including infections, tumours, blood dyscrasias, dysproteinemias, immunologic disorders, or drug intake. 3 4,5 These 2 previous cases received PEG-IFNα-2a, whereas our patient received PEG-IFNα-2b; therefore, it appears that EAC has now been associated with either the α-2a or α-2b types of pegylated interferons. Although we cannot safely exclude that, in our case, the onset of EAC is due to BOC, it is unclear if BOC may have played a role in the development of this dermatosis.…”

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confidence: 99%

“…EAC is a figurate dermatosis presenting as 1 or multiple, usually asymptomatic erythematous macules or urticarial papules, which enlarge by peripheral extension to form ringed, arcuate, or polycyclic lesions with overlying scale or without surface change. 3 EAC is typically classified into a superficial or a deep type, depending on the appearance of the perivascular lymphocytic infiltrate. Furthermore, the superficial variant is characterized by epidermal changes such as focal spongiosis, focal parakeratosis, and epidermal hyperplasia.…”

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Erythema Annulare Centrifugum in the Era of Triple Therapy with Boceprevir plus Pegylated Interferon α-2b and Ribavirin for Hepatitis C Virus Infection

et al. 2015

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Boceprevir (BOC) is an inhibitor of hepatitis C protease nonstructural protein 3, an enzyme that cleaves the hepatitis C virus polyprotein at specific sites to form functional proteins necessary for viral replication. Currently, BOC is approved for the treatment of chronic hepatitis C (CHC) virus genotype 1 infection in combination with pegylated interferon α (PEG-IFNα) and ribavirin (RBV) in adults (>18 years old) with compensated liver disease who are previously untreated or who have failed previous PEG-IFNα/RBV treatment. 1 Although adverse events are well established for standard PEG-IFNα/RBV therapy, many new side effects have been encountered with the advent of the triple therapy. We describe the third case of erythema annulare centrifugum (EAC) during a therapy with PEG-INFα/RBV for CHC. It is the first associated with the pegylated interferon α 2-b (PEG-IFNα-2b) in the era of triple therapy with BOC.A 67-year-old man with a 10-year history of genotype 1 CHC (previously treated unsuccessfully with 2 cycles of PEG-IFNα-2b/RBV) presented for evaluation of an asymptomatic skin eruption on his lower extremities that appeared 12 days after the start of BOC-based triple therapy with PEG-INFα-2b/RBV. Physical examination showed several nonscaling, slightly raised, annular, and polycyclic erythematous plaques ( Figure 1A). The patient reported that the lesions extended progressively with central resolution; moreover, he denied other health problems and prior drug intake. Laboratory examinations-including thyroid, hepatic, renal, and lipid profiles, as well as glycemia and paraneoplastic markersshowed no alteration. Antinuclear and Lyme antibodies were negative. A skin lesion biopsy was compatible with the clinical diagnosis of EAC by revealing superficial perivascular infiltrate of lymphocytes and eosinophils associated with exocytosis of inflammatory cells and spongiosis ( Figure 1B). Since drug discontinuation is not recommended in cases of skin eruption with limited extension during BOC-based triple therapy, 2 we decided to continue the therapy and to treat the EAC with topical clobetasol propionate foam (0.05%) once a day, with significant improvement after 1 month.EAC is a figurate dermatosis presenting as 1 or multiple, usually asymptomatic erythematous macules or urticarial papules, which enlarge by peripheral extension to form ringed, arcuate, or polycyclic lesions with overlying scale or without surface change. 3 EAC is typically classified into a

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Erythema annulare centrifugum: Deep variant with vasculitis like histopathology

Cited by 8 publications

References 2 publications

Possibly drug-induced palpable migratory arciform erythema

Possibly drug-induced palpable migratory arciform erythema

Deep variant of Erythema Annulare Centrifugum

Erythema Annulare Centrifugum in the Era of Triple Therapy with Boceprevir plus Pegylated Interferon α-2b and Ribavirin for Hepatitis C Virus Infection

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