Erythema anulare centrifugum | |
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Other names | Deep gyrate erythema, Erythema perstans, Palpable migrating erythema and Superficial gyrate erythema [1] |
Specialty | Dermatology |
Erythema annulare centrifugum (EAC), is a descriptive term for a class of skin lesion [2] presenting redness (erythema) in a ring form (anulare) that spreads from a center (centrifugum). It was first described by Darier in 1916. [3] [4] [5] Many different terms have been used to classify these types of lesions and it is still controversial on what exactly defines EAC. Some of the types include annular erythema (deep and superficial), erythema perstans, erythema gyratum perstans, erythema gyratum repens, darier erythema (deep gyrate erythema) and erythema figuratum perstans.
Occurring at any age these lesions appear as raised pink-red ring or bulls-eye marks. They range in size from 0.5–8 cm (0.20–3.15 in). The lesions sometimes increase size and spread over time and may not be complete rings but irregular shapes. Distribution is usually on the thighs and legs but can also appear on the upper extremities, areas not exposed to sunlight, trunk or face. Currently EAC is not known to be contagious, but as many cases are incorrectly diagnosed as EAC, it is difficult to be certain.
Often no specific cause for the eruptions is found. However, it is sometimes linked to underlying diseases and conditions such as:
A skin biopsy can be performed to test for EAC; tests should be performed to rule out other possible diseases such as: pityriasis rosea, tinea corporis, psoriasis, nummular eczema, atopic dermatitis, drug reaction, erythema migrans and other rashes.
No treatment is usually needed as they usually go away anywhere from months to years. The lesions may last from anywhere between 4 weeks to 34 years with an average duration of 11 months. If caused by an underlying disease or malignancy, then treating and removing the disease or malignancy will stop the lesions. It usually doesn't require treatment, but topical corticosteroids may be helpful [8] in reducing redness, swelling and itchiness.
Some supported and not supported methods of having an effect on EAC include:
It is very rare and estimated to affect 1 in 100,000 per year.[ citation needed ] Because of its rarity the documentation, cases and information are sparse and not a huge amount is known for certain, meaning that EAC could actually be a set of many un-classified skin lesions. It is known to occur at all ages and all genders equally.[ citation needed ] Some articles state that women are more likely to be affected than men.[ citation needed ]
Tinea versicolor is a condition characterized by a skin eruption on the trunk and proximal extremities. The majority of tinea versicolor is caused by the fungus Malassezia globosa, although Malassezia furfur is responsible for a small number of cases. These yeasts are normally found on the human skin and become troublesome only under certain conditions, such as a warm and humid environment, although the exact conditions that cause initiation of the disease process are poorly understood.
Tinea corporis is a fungal infection of the body, similar to other forms of tinea. Specifically, it is a type of dermatophytosis that appears on the arms and legs, especially on glabrous skin; however, it may occur on any superficial part of the body.
Tinea barbae is a fungal infection of the hair. Tinea barbae is due to a dermatophytic infection around the bearded area of men. Generally, the infection occurs as a follicular inflammation, or as a cutaneous granulomatous lesion, i.e. a chronic inflammatory reaction. It is one of the causes of folliculitis. It is most common among agricultural workers, as the transmission is more common from animal-to-human than human-to-human. The most common causes are Trichophyton mentagrophytes and T. verrucosum.
Grover's disease (GD) is a polymorphic, pruritic, papulovesicular dermatosis characterized histologically by acantholysis with or without dyskeratosis. Once confirmed, most cases of Grover's disease last six to twelve months, which is why it was originally called "transient". However it may last much longer. Nevertheless, it is not to be confused with relapsing linear acantholytic dermatosis.
Spongiosis is mainly intercellular edema in the epidermis, and is characteristic of eczematous dermatitis, manifested clinically by intraepidermal vesicles, "juicy" papules, and/or lichenification. It is a severe case of eczema that affects the epidermis, dermis or subcutaneous skin tissues. The three types of spongiotic dermatitis are acute, subacute and chronic. A dermatologist can diagnose acute spongiotic dermatitis by examining the skin during an office visit, but a biopsy is needed for an accurate diagnosis of the type.
Lupus miliaris disseminatus faciei, also known as acne agminata, is a disease with a similar appearance to acne vulgaris. The cause of LMDF is unknown.
Dermatitis repens, also known as acrodermatitis continua, acrodermatitis perstans, pustular acrodermatitis, acrodermatitis continua of Hallopeau, acrodermatitis continua suppurativa Hallopeau, Hallopeau's acrodermatitis, Hallopeau's acrodermatitis continua, and dermatitis repens Crocker, is a rare, sterile, pustular eruption of the fingers and toes that slowly extends proximally.
Subacute cutaneous lupus erythematosus is a clinically distinct subset of cases of lupus erythematosus that is most often present in white women aged 15 to 40, consisting of skin lesions that are scaly and evolve as poly-cyclic annular lesions or plaques similar to those of plaque psoriasis.
Palisaded neutrophilic and granulomatous dermaititis (PNGS) is usually associated with a well-defined connective tissue disease, lupus erythematosus or rheumatoid arthritis most commonly, and often presents with eroded or ulcerated symmetrically distributed umbilicated papules or nodules on the elbows.
Granulosis rubra nasi is a rare familial disease of children, occurring on the nose, cheeks, and chin, characterized by diffuse redness, persistent excessive sweating, and small dark red papules that disappear on diascopic pressure.
Small plaque parapsoriasis characteristically occurs with skin lesions that are round, oval, discrete patches or thin plaques, mainly on the trunk.
In dermatology, erythema multiforme major is a form of rash with skin loss or epidermal detachment.
Seborrheic-like psoriasis is a skin condition characterized by psoriasis with an overlapping seborrheic dermatitis.
Tinea imbricata is a superficial fungal infection of the skin limited to southwest Polynesia, Melanesia, Southeast Asia, India, and Central America. The skin lesions, often itchy, occur mainly in the torso and limbs. The name tinea imbricata is derived from the Latin for "tiled" (imbricatus) since the lesions are often lamellar. The lesions are often treated with griseofulvin or terbinafine.
Subcutaneous granuloma annulare is a skin condition of unknown cause, most commonly affecting children, with girls affected twice as commonly as boys, characterized by skin lesions most often on the lower legs.
Airbag dermatitis is skin irritation secondary to the deployment of airbags. The diagnosis of "air bag dermatitis" is relatively recent; the first case was reported in 1994.
Recurrent toxin-mediated perineal erythema is an unusual condition that presents 2–3 days after a throat infection as a fine diffuse macular erythema of the perineal region.
Acute cutaneous lupus erythematosus is a cutaneous condition characterized by a bilateral malar rash and lesions that tend to be transient, and that follow sun exposure. The acute form is distinct from chronic and subacute cutaneous lupus erythematosus, which may have different types of skin lesions. Cutaneous lupus erythematosus is associated with both lupus erythematosus-specific lesions and cutaneous manifestations that are not specific to lupus erythematosus, such as oral ulcers and urticaria. Because of the diagnostic criteria used to diagnose systemic lupus erythematosus, a patient with only cutaneous manifestations may be diagnosed with the systemic form of the disease.
Sarcoidosis, an inflammatory disease, involves the skin in about 25% of patients. The most common lesions are erythema nodosum, plaques, maculopapular eruptions, subcutaneous nodules, and lupus pernio. Treatment is not required, since the lesions usually resolve spontaneously in two to four weeks. Although it may be disfiguring, cutaneous sarcoidosis rarely causes major problems.