“…Erythema gyratum repens was first described in 1952 by Gammel, who observed it in a patient with breast cancer. 50 The Latin term repens, meaning ''to crawl'' or ''to creep,'' describes the striking, characteristic, expanding erythematous borders in this rare paraneoplastic condition. 51 Approximately 50 cases have been reported in the literature.…”
“…Erythema gyratum repens was first described in 1952 by Gammel, who observed it in a patient with breast cancer. 50 The Latin term repens, meaning ''to crawl'' or ''to creep,'' describes the striking, characteristic, expanding erythematous borders in this rare paraneoplastic condition. 51 Approximately 50 cases have been reported in the literature.…”
“…She died 2 months after diagnosis; the rash had not resolved. Figure 1Annular, erythematous rash lined by trailing edge of scale, characteristic of erythema gyratum repens in this patient with cholangiocarcinoma.Figure 2CT abdomen showing an 18×17 mm hypodense lesion in the liver hilar region (yellow arrow), suggestive of cholangiocarcinoma.Learning pointsErythema gyratum repens (EGR), first described by Gammel,1 in 1952, is a rare paraneoplastic syndrome typically associated with an underlying malignancy. The most common include lung carcinoma, oesophageal carcinoma and breast carcinoma 2…”
Section: Descriptionmentioning
confidence: 86%
“…Erythema gyratum repens (EGR), first described by Gammel,1 in 1952, is a rare paraneoplastic syndrome typically associated with an underlying malignancy. The most common include lung carcinoma, oesophageal carcinoma and breast carcinoma 2…”
DESCRIPTIONA 77-year-old woman was evaluated for a 3-week history of rash on her lower limbs. The eruption began as a small erythematous macule, and gradually enlarged with time. The patient had atrial fibrillation on anticoagulation therapy. On physical examination, there were annular, erythematous lesions that appeared in concentric, raised bands lined by trailing edge of scales over the lateral aspect of her right thigh (figure 1). A clinical diagnosis of erythema gyratum repens was made. The remainder of her examination was remarkable for scleral icterus, abdominal distension with clinical evidence of ascites and inguinal lymphadenopathy. A CT scan revealed a hypodense lesion measuring 18×17 mm in the liver hilar region, suggestive of cholangiocarcinoma, with infiltration of adjacent segment 8. There was also associated bile duct dilation and thrombosis of the portal vein (figure 2). The patient and her family opted for conservative palliative management of her intra-abdominal malignancy. A trial of topical corticosteroids was initiated. She died 2 months after diagnosis; the rash had not resolved.
Learning points▸ Erythema gyratum repens (EGR), first described by Gammel, 1 in 1952, is a rare paraneoplastic syndrome typically associated with an underlying malignancy. The most common include lung carcinoma, oesophageal carcinoma and breast carcinoma. Contributors VL contributed to the content and organisation of information. MML contributed to the retrieval of data, content and organisation of information. SY contributed to content and organisation of information.Competing interests None declared.
Patient consent Obtained.Provenance and peer review Not commissioned; externally peer reviewed.
REFERENCES
“…Nach der Erstbeschreibung des Erythema gyratum repens durch Gammel im Jahre 1952 [8] Aufgrund der fehlenden Hämatoto-xizität und des nicht bestimmten 6-Mercaptopurin-Nukleotid-Wirkspiegels kann jedoch anhand der vorliegenden Daten kein sicherer Zusammenhang mit den nachgewiesenen TPMTMutationen hergestellt werden.…”
This is the first report of an erythema gyratum repens in association with azathioprine treatment in an autoimmune hepatitis type I patient with proven common polymorphism in the TPMT gene.
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