Erythema Elevatum Diutinum.

Erythema elevatum et diutinum

“…The infiltrate consisted mainly of lymphocytes, but at some places there were up to 30% polymorphonuclear leucocytes, among which some eosinophils. This character of the inflammation is also observed by Audrey [1] and Friihwald [4].…”

“…Distinct fragmentation of the nuclei of the polymorphonuclear leucocytes was observed in an excision of a noneroded papule. According to Haber [1] this has also been observed by Favera. The extravasation of red blood cells observed also in this case, which with a fair degree of certainty was no artificial haem or rhage, is seen in allergic vascular reactions, as also is the fragm en tation of the nuclei of the polyinorphonuclears.…”

“…The large tum ours, the size of half a lemon, as observed by Friihwald, resemble the large-papulous form as observed e.g. by Huber [1]. Friihtvald's [4] case is of great importance as it proves that the two processes, both with the fineand the largepapules, are manifestations of one and the same clinical picture.…”

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Two forms of erythem a elevatum et diutinum have been described: (a) the type with elevated large papules especially on the ends of the extrem ities (e.g., the patients of Hutchinson [1], Haber [1] and Ketron [2]), and (b) the type with smaller and sometimes annularly arranged lesions especially on the extensor sides of the arms and the backs of the bands (e.g., the patient of Haber and Russell [3] and the female patient to be described in the following pages).The patient described by Friihivald [4] showed both the large papules on the articular ends and the fine-papulous type on the extensor side of the lower arms.

Case reportA female patient, born on December 30, 1913, was first seen by us on June 25, 1953.Past history and anamnesis: The skin affection began on the left arm and spread over the two arms, the neck, face and upper legs in a few months' time. The lesions were first red.

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Cutaneous Vasculitis

“…Certain clinical forms of erythema elevatum diutinur}l (EED) arc now referred to as extra cellular cholesterosis. Clinically EED is a rare skin disorder, consisting of persistent, slowly evolving nodules and plaques symmetrically Located over bony prominences, knuckles, elbows and knees [26]. Lesions may appear on the pretibial surfaces, around the wrists or ankles and sometimes on the buttocks.…”