Erythema annulare centrifugum
Encyclopedia
Erythema annulare centrifugum (also known as "Deep gyrate erythema," "Erythema perstans," "Palpable migrating erythema", and "Superficial gyrate erythema") is a descriptive term for a skin lesion. The lesions form consists of redness (erythema
) in a ring form (annulare) that spreads from the center (centrifugum). EAC was first described by Darier
in 1916. 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 (deep and superficial) annular erythema, erythema perstans, erythema gyratum perstans, erythema gyratum repens, darier erythema (Deep gyrate erythema & Deep gyrate erythema) and erythema figuratum perstans.
es.
and itchiness.
Some supported and not supported methods of having an effect on EAC include:
Erythema
Erythema is redness of the skin, caused by hyperemia of the capillaries in the lower layers of the skin. It occurs with any skin injury, infection, or inflammation...
) in a ring form (annulare) that spreads from the center (centrifugum). EAC was first described by Darier
Ferdinand-Jean Darier
Ferdinand-Jean Darier was a French physician, pathologist and dermatologist called the "father of modern dermatology in France".-Medical:...
in 1916. 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 (deep and superficial) annular erythema, erythema perstans, erythema gyratum perstans, erythema gyratum repens, darier erythema (Deep gyrate erythema & Deep gyrate erythema) and erythema figuratum perstans.
Symptoms
Occurring at any age these lesions appear as raised pink-red ring or bulls-eye marks. They range in size from 0.5 –. 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.Diagnosis
There are no specific tests that 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 rashRash
A rash is a change of the skin which affects its color, appearance or texture. A rash may be localized in one part of the body, or affect all the skin. Rashes may cause the skin to change color, itch, become warm, bumpy, chapped, dry, cracked or blistered, swell and may be painful. The causes, and...
es.
Causes
Often no specific cause for the eruptions is found. However, it is sometimes linked to underlying diseases and conditions such as:- Food (including blue cheese or tomatoes).
- Fungal, Bacterial and Viral infections such as sinusitisSinusitisSinusitis is inflammation of the paranasal sinuses, which may be due to infection, allergy, or autoimmune issues. Most cases are due to a viral infection and resolve over the course of 10 days...
, tuberculosisTuberculosisTuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...
, candidiasisCandidiasisThrush redirects here. For the hoof infection see Thrush .Candidiasis or thrush is a fungal infection of any of the Candida species , of which Candida albicans is the most common...
or tineaTineaTinea is a general term used to describe skin mycoses. The term ringworm is even less precise, but is usually considered a synonym.It is sometimes equated with dermatophytosis, and it is true that most conditions identified as "tinea" are members of the imperfect fungi that make up the dermatophytes...
. - Drugs including finasterideFinasterideFinasteride is a synthetic antiandrogen that inhibits type II 5-alpha reductase, the enzyme that converts testosterone to dihydrotestosterone...
, chloroquineChloroquineChloroquine is a 4-aminoquinoline drug used in the treatment or prevention of malaria.-History:Chloroquine , N'--N,N-diethyl-pentane-1,4-diamine, was discovered in 1934 by Hans Andersag and co-workers at the Bayer laboratories who named it "Resochin". It was ignored for a decade because it was...
, hydroxychloroquineHydroxychloroquineHydroxychloroquine is an antimalarial drug, sold under the trade names Plaquenil,Axemal, Dolquine, and Quensyl, also used to reduce inflammation in the treatment of rheumatoid arthritis and lupus...
, oestrogen, penicillinPenicillinPenicillin is a group of antibiotics derived from Penicillium fungi. They include penicillin G, procaine penicillin, benzathine penicillin, and penicillin V....
and amitriptylineAmitriptylineAmitriptyline is a tricyclic antidepressant . It is the most widely used TCA and has at least equal efficacy against depression as the newer class of SSRIs...
. - CANCER-sensitivity to malignancy (especially the type known as erythema gyratum perstans, in which there are concentric and whirling rings).
- Primary biliary cirrhosisPrimary biliary cirrhosisPrimary biliary cirrhosis, often abbreviated PBC, is an autoimmune disease of the liver marked by the slow progressive destruction of the small bile ducts within the liver. When these ducts are damaged, bile builds up in the liver and over time damages the tissue. This can lead to scarring,...
. - Graves disease.
- AppendicitisAppendicitisAppendicitis is a condition characterized by inflammation of the appendix. It is classified as a medical emergency and many cases require removal of the inflamed appendix, either by laparotomy or laparoscopy. Untreated, mortality is high, mainly because of the risk of rupture leading to...
. - LupusSystemic lupus erythematosusSystemic lupus erythematosus , often abbreviated to SLE or lupus, is a systemic autoimmune disease that can affect any part of the body. As occurs in other autoimmune diseases, the immune system attacks the body's cells and tissue, resulting in inflammation and tissue damage...
- PregnancyPregnancyPregnancy refers to the fertilization and development of one or more offspring, known as a fetus or embryo, in a woman's uterus. In a pregnancy, there can be multiple gestations, as in the case of twins or triplets...
(EAC usually disappears/stops soon after delivery of baby). - HormoneHormoneA hormone is a chemical released by a cell or a gland in one part of the body that sends out messages that affect cells in other parts of the organism. Only a small amount of hormone is required to alter cell metabolism. In essence, it is a chemical messenger that transports a signal from one...
(Contraceptive Pill, Stress, Hormone Drugs) - Lyme DiseaseLyme diseaseLyme disease, or Lyme borreliosis, is an emerging infectious disease caused by at least three species of bacteria belonging to the genus Borrelia. Borrelia burgdorferi sensu stricto is the main cause of Lyme disease in the United States, whereas Borrelia afzelii and Borrelia garinii cause most...
Treatment
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 in reducing redness, swellingSwelling (medical)
In medical parlance, swelling is the transient enlargement or protuberance in the body and may include tumors. According to cause, it may be congenital, traumatic, inflammatory, neoplastic or miscellaneous....
and itchiness.
Some supported and not supported methods of having an effect on EAC include:
- Photosensitive so it can be moved/reduced with appropriate sunlight.
- Vitamin D
- Immune system - hence it will increase in size/number when the immune system is low or overloaded.
- Hormone Drugs
- Disulone
- Topical calcipotriol - a topical vitamin D derivative has been known to be beneficial