Possibly drug-induced palpable migratory arciform erythema

Abstract

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.

Recurrent episodes of palpable migratory arciform erythema associated with IVIg infusions

“…Presumably, the large majority of cases present idiopathically. In the only other report that documents two cases of potential drug-induced PMAE, the specific medication is not clear owing to multiple medication administration [4]. To date, this is the first report of recurrent PMAE in association with IVIg infusions.…”

“…Although some clinicians have reported success in using systemic antibiotics to induce remission of PMAE, no causative infectious etiology has been identified. Other proposed associations based on case reports have included the administration of several different medications, HIV infection, and the presence of a preceding B-cell pseudolymphoma [3][4][5]. Presumably, the large majority of cases present idiopathically.…”