Erythema Elevatum Diutinum

A Variant of Rheumatoid Arthritis resembling Palindromic Rheumatism

“…Much confusion seems to have arisen as a result of the inclusion in the original account of erythema elevatum diutinum by Crocker and Williams (1894) of Bury's case which most dermatologists believe to have been one of granuloma annulare (cutaneous type). While Graham Little originally held (1908) that erythema elevatum diutinum was a variety of granuloma annulare, a view still held by many, he and Goldsmith later thought (in a discussion of Gray's case, 1932) that erythema elevatum diutinum differed from granuloma annulare in the absence of discrete nodules: this is a view which has been championed by Combes and Bluefarb (1940), who point out that erythema elevatum diutinum is bilaterally symmetrical, whereas granuloma annulare is seldom so: it affects middle-aged and old men, as against the children and young females with granuloma annulare. It is a flat raised red plaque.…”