THE ERYTHEMA ANNULARE CENTRIFUGUM, A REVIEW / EL ERITEMA ANULAR CENTRIFUGO, REVISION

 

The Erythema Annulare Centrifugum,
Looking for the origin, !!!
 
 El Eritema Anular Centrifugo,
Buscando el origen. !

EDITORIAL ENGLISH
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Hello DERMAGIC friends, select this interesting title for a disease described by DARIER in the year 1916 under the name of Erithema Annular Centrifuge. Classified within the chapter of the  GYRATE ERYTHEMAS, where two (2) variants can be described: NOT ASSOCIATED WITH MALIGNANT diseases: multiple causes. And another variant ASSOCIATED WITH INTERNAL MALIGNANCY called Paraneoplastic erythema annulare centrifugum eruption:( PEACE).

This disease or dermatological sign has several forms of presentation: A deep and superficial form that includes several subtypes: With vesiculation, papule, pruritus, and desquamation. Lesions may or may not be migratory. It can occur in adults and children. Many times it disappears after the cause is identified and treated.

If we analyze with detail these bibliographical references we can reach the following conclusions:

Clinical Entity: Gyrate Erythema

1.) types:

a.) Deep. 

B.) Superficial: Subtypes:  Bullous, papulatum, and scaly with or without pruritus.

 2.) Etiology: 

 

A hypersensitivity response to unrecognized antigens is suspected. 

 3.) associations: 

 

a.) Foods:

Tomatoes, blue cheese. 

b.) Drugs:

Cimetidin, Antimalarials, Penicillin, Salicylates, Estrogen-Progesteron, K vitamin, piroxicam,   ampicillin and others 

c.) LIVING Agents: 

Molluscum Contagiosum, Epstein Barr virus, ascariasis, yersiniosis, Streptococcal infections, Mycobateriun tuberculosis, Dermatophytes, Cándida albicans, herpes zoster, borrelia burgdorferi.
 

d.) Colagen diseases:

 

Lupus, Sjogren syndrome, CREST syndrome.
 

e.) Bullous disease: 

 

Bullous Pemphigoid, lineal IgA disease, pemphigus. 

f.) Scaly disease: 

Psoriasis 

g.) Granulomatous diseases: 

Sarcoidosis, Tuberculosis 

h.) maLignant diseases: 

 
Myeloma, Leukemia, Hodgkin's disease AND OTHERS.

i.) Endocrine Diseases: 

 

Tiroiditis of Hashimoto, Grave's disease. 

j.) Eosinophilic diseases:

 

Hypereosinophilic syndrome. 

K.) Inflammatory bowel diseases:
 

Crohn's disease

I.) Miscelaneous:

Idiopatic, Familial


If we unify ALL of these data then we could consider it as a DERMATOLOGIC SIGN associated to non-malignant entities and associated with MALIGNANT entities, being then considered another skin marker of malignancy. So if you find this disease in your daily practice. Think about this classification which will help better identify the cause and request for the respective laboratory tests to truly recognize that causes it.


In the 107 references the facts, in the attach the erythema annulare centrifugum

Greetings to all !!.

Dr. José Lapenta.



EDITORIAL ESPANOL
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Hola Amigos DERMAGICOS, seleccione este interesante titulo para una enfermedad descrita por DARIER en el año de 1.916 bajo el nombre de Eritema Anular Centrifugo. Clasificado dentro del capitulo de los ERITEMAS FIGURADOS, donde se pueden describir dos (2) variantes: NO ASOCIADO A MALIGNIDAD: de múltiples causas. Y otra variante ASOCIADA A MALIGNIDAD INTERNA denominada ERITEMA ANULAR CENTRIFUGO PARANEOPLASICO.


Esta enfermedad o SIGNO dermatológico tiene varias formas de presentación: Una forma profunda y otra superficial que incluye a su vez varios subtipos: Con vesiculación, pápulas,  prurito, y descamación. Las lesiones pueden ser o no migratorias. Puede presentarse en adultos y niños. Muchas veces desaparece después de identificada y tratada la causa.

Si analizamos con detalle estas referencias bibliográficas podemos sacar las siguientes conclusiones:
 
Entidad Clínica: Eritema figurado


1.) Tipos: 

1.A.) Profundo.

1.B.) Superficial:

subtipos: Vesiculoso  papuloso y escamoso con o sin prurito 

2.) Etiologia: 
 
Se sospecha de una respuesta de hipersensiblidad a antigenos desconocidos.

3.) Asociaciones:
 
a.) Comidas:

Tomates, queso azul.

b.) Drogas:

Cimetidina, Antimalaricos, Penicilina, Salicilatos, Estrogenos, Progesterona, K vitamin, piroxicam, ampicilina y otros

c.) Agentes vivos: 

Molusco contagioso, Epstein barr. ascariasis, yersinia, Infecciones estreptococcicas, Mycobateriun tuberculosis, Dermatofitos, Candida albicans, herpes zoster, borrelia burgdorferi 

d.) Enfermedades del colageno: 

Lupus, Sindrome de Sjogren, CREST sindrome. 

e.) Enfermedades ampollares: 

Penfigoide ampollar, penfigo, Enfermedad por IgA lineal. 

f.) Enfermedades escamosas:  

Psoriasis. 

g.) Enfermedades granulomatosas:
 
Sarcoidosis, Tuberculosis. 

h.) Enfermedades malignas: 

Mieloma multiple, Leucemia, Enfermedad de Hodgkin y otros.

i.) Enfermedades endocrinas: 

Tiroiditis de Hashimoto, enfermedad de Graves. 

j.) Enfermedades eosinofilicas: 

Sindrome hipereosinofilico.

k.) Enfermedades intestinal inflamatoria:

Enfermedad de Crohn

k.) Miscelaneos:

Idiopatico, familiar.

Si unificamos TODOS estos datos entonces lo podríamos considerar como SIGNO DERMATOLOGICO asociado a entidades NO MALIGNAS Y asociado a entidades MALIGNAS, siendo entonces considerado otro marcador cutáneo de malignidad. De modo que si les presenta esta enfermedad en su practica diaria. Piensen en esta clasificación la cual les ayudara a identificar mejor la causa y pedir los respectivos exámenes de laboratorio para reconocer verdaderamente que lo provoco.
 
En las referencias los hechos ...

Saludos a todos.

Dr. José Lapenta R. 

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REFERENCIAS BIBLIOGRAFICAS / BIBLIOGRAPHICAL REFERENCES
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1.) Gyrate erythema.
2.) [Erythema annulare centrifugum Darier].
3.) Recurrent acute appendicitis with erythema annulare centrifugum.
4.) Erythema annulare centrifugum, angio-oedema in lupus vulgaris.
5.) Erythema annulare centrifugum. A case due to tuberculosis.
6.) [Erythema annulare centrifugum of the legs symptomatic of prostate adenocarcinoma; a specific paraneoplastic syndrome]?
7.) Erythema annulare centrifugum and Hodgkin's disease: association with disease activity.
8.) On erythema annulare centrifugum-type of psoriasis.
9.) Annular psoriasiform eruption with lymphocytic
infiltration of the epidermis: a variant of acute psoriasis?
10.) Psoriasis: odd varieties in the adult.
11.) [Localized form of psoriasis of the erythema annulare centrifugum type with pustulation]
12.) [Psoriasis and pustular psoriasis of the erythema annulare centrifugum type (3 cases)].
13.) Erythema annulare centrifugum induced by molluscum contagiosum.
14.) Erythema annulare centrifugum and molluscum contagiosum.
15.) [Hypereosinophilic syndrome. Cutaneous picture of "erythema annulare centrifugum"--comparison with ultrastructural study].
16.) [Hypereosinophilic syndrome. Centrifugal annular erythema as an initial manifestation].
17.) Erythema annulare centrifugum as the presenting sign of the hypereosinophilic syndrome: observations on therapy.
18.) [Erythema annulare centrifugum as a symptom in acute myeloid leukemia].
19.) Annular erythemas in infants associated with autoimmune disorders in their mothers. Report on three cases.
20.) Ampicillin induced erythema annulare centrifugum.
21.) [Specific leukemic infiltration with the appearance of erythema annulare centrifugum (Darier) in chronic lymphadenosis].
22.) Unusual cutaneous associations of a malignant carcinoid tumour of the bronchus--erythema annulare centrifugum and white banding of the toe nails.
23.) [The bullous variant of erythema annulare centrifugum Darier in Candida albicans infections].
24.) [Migrant eruptions in lupus erythematosus. Apropos of a case of lupus erythematosis gyratus repens].
25.) Erythema annulare centrifugum coincident with Epstein-Barr virus infection in an infant.
26.) Erythema annulare centrifugum and relapsing polychondritis.
27.) Vulvar disease in children: a clinical audit of 130 cases.
28.) Amitriptyline-induced erythema annulare centrifugum.
29.) Drugs causing fixed eruptions: a study of 450 cases.
30.) Erythema annulare centrifugum in a patient with polyglandular autoimmune disease type 1.
31.) Recurrent ringed lesion of the sole: erythema annulare centrifugum.
32.) Erythema annulare centrifugum associated with pregnancy.
33.) [Annular erythema in childhood--a new eosinophilic dermatosis].
34.) Erythema annulare centrifugum and intestinal Candida albicans infection--coincidence or connection?
35.) Dermacase. Erythema annulare centrifugum.
36.) Psoriasis: changing clinical patterns.
37.) Erythema annulare centrifugum and Escherichia coli urinary infection.
38.) Sarcoidosis presenting as erythema annulare centrifugum.
39.) [Recurrent annular erythema--cutaneous manifestation of Sjogren syndrome with anti SS-A (Ro) and anti SS-B (La) antibodies].
40.) Non-small-cell lung cancer with multiple paraneoplastic syndromes.
41.) [Darier's erythema annulare centrifugum of neonatal onset with a 15 years' follow-up. Efficacy of interferon and role of cytokines].
42.) Erythema annulare centrifugum unresponsive to immunosuppressive therapy.
43.) Annular vasculitis associated with pregnancy.
44.) Inflammatory carcinoma masquerading as erythema annulare centrifugum.
45.) [Darier's erythema annulare centrifugum and primary Vaquez polycythemia]
46.) Recurrent annular erythema with anti-SSA/Ro and anti-SSB/La antibodies localized on palms and fingers in an elderly man.
47.) Clinical and immunological analysis of annular erythema associated with Sjogren syndrome.
48.) Clinical, serological and immunogenetic features of Japanese anti-Ro/SS-A-positive patients with annular erythema.
49.) Persistent annular erythema of infancy.
50.) HLA antigens in anti-Ro(SS-A)-positive patients with recurrent annular erythema.
51.) Urticated annular erythema: a new manifestation of Sjogren's syndrome.
52.) Recurrent annular erythema associated with anti-SS-
53.) Erythema annulare centrifugum associated with gold sodium thiomalate therapy.
54.) Annular erythema. A comparative study of Sjogren syndrome with subacute cutaneous lupus erythematosus.
55.) Annular erythema associated with Sjogren's syndrome: a variant of systemic lupus erythematosus [see comments]
56.) Lymphocyte response to staphylococcal enterotoxin B in patients with annular erythema associated with Sjogren syndrome.
57.) ICAM-1 and LFA-1 expressions in the lesional skin of annular erythema associated with Sjogren syndrome.
58.) Annular erythema associated with primary Sjogren syndrome: analysis of T cell subsets in cutaneous infiltrates [see comments]
59.) Annular erythema in identical twins.
60.) Annular erythema: a possible association with primary Sjogren's syndrome.
61.) Neonatal lupus syndrome and microtubular structure.
62.) Erythema annulare of infancy.
63.) An annular erythema of infancy.
64.)Reactive annular erythema after intramuscular vitamin K.
65.) Annular erythema of infancy.
66.) [Erythema annulare centrifugum revealing linear IgA dermatitis of childhood]
67.) Erythema annulare centrifugum: an unusual case due to hydroxychloroquine sulfate.
68.) 'Persistent' annular erythema of infancy.
69.) Erythema annulare centrifugum associated with ascariasis.
70.) Annular erythema of infancy.
71.) Annular erythema as an unusual manifestation of chronic disseminated lupus erythematosus.
72.) Multiple annular erythema [letter]
73.) Reactive erythemas: erythema annulare centrifugum and erythema gyratum repens.
74.) [Squamous erythema annulare centrifugum]
75.) Annular erythema associated with Sjogren's syndrome [letter; comment]
76.) An intensive care unit nurse with a recurring annular lesion. Erythema annulare centrifugum (EAC).
77.) Erythema annular centrifugum in Q fever.
78.) Erythema annulare centrifugum caused by hydrochlorothiazide-induced interstitial nephritis.
79.) [Erythema annulare centrifugum disclosing hyperthyroidism]
80.) Eruption resembling erythema annulare centrifugum due to thiacetazone [letter]
81.) [Erythema annulare centrifugum caused by aldactone]
82.) [On the physiopathology of erythema annulare centrifugum]
83.) Erythema annulare centrifugum associated with liver disease.
84.) [Erythema annulare centrifugum and Hashimoto's thyroiditis]
85.) Erythema annulare centrifugum associated with piroxicam [letter]
86.) Annular erythema with histologic features of leukocytoclastic vasculitis in ulcerative colitis.
87.) Erythema annulare centrifugum and malignant histiocytosis--report of a case.
88.) Pityrosporum infection in an infant with lesions resembling erythema annulare centrifugum.
89.) Erythema annulare centrifugum: a review of 24 cases with special reference to its association with underlying disease.
90.) [Pemphigoid with recurrence of the centrifugal-development bullous annular erythema type]
91.) [Bullous pemphigoid with an erythema annulare centrifugum appearance and a bullous border]
92.) [Erythema annulare centrifugum and antinuclear antibodies]
93.) Erythema annulare centrifugum. A case due to tuberculosis.
94.) Erythema annulare centrifugum and Graves' disease [letter]
95.) Cimetidine-induced erythema annulare centrifugum: no cross-sensitivity with ranitidine.
96.) [Nosologic problems posed by a case of desquamative erythema annulare centrifugum]].
97.) [Erythema annulare centrifugum Darier as a reaction form in diseases of the reticulo-histiocyte system].
98.) [Erythema annulare centrifugum of Darier, squamous variety].
99.) [Erythema annulare centrifugum with loco-regional recurrences during the course of tuberculous coxitis. Focal reaction to tuberculin].
100.) The Gyrate Erythemas
101.) Erythema annulare centrifugum: case due to hypersensivite to blue cheese penicillium.
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1.) Gyrate erythema.
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Dermatol Clin 1985 Jan;3(1):129-39

White JW Jr

The gyrate erythemas consist of a nonspecific group (often called erythema annulare centrifugum) for which the cause is usually unknown, and three specific types (erythema marginatum rheumaticum, erythema chronicum migrans [Lyme disease], and erythema gyratum repens). The first specific type, erythema marginatum rheumaticum, has become extremely rare with the decline of its associated disease, rheumatic fever. The second specific type, erythema chronicum migrans, is caused by a spirochete transmitted by the I. ricinus complex of ticks. The third specific type, erythema gyratum repens, is uncommon, morphologically distinctive, and an indicator of serious disease, usually internal malignancy, in almost every instance.

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2.) [Erythema annulare centrifugum Darier].
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Hautarzt 1979 Dec;30(12):673-5 Related Articles, Books, LinkOut

[Article in German]

Baurle G

The symptoms of erythema anulare centrifugum Darier are demonstrated in a 60-year-old patient. A paraneoplastic syndrome was sufficiently ruled out. The skin lesions quickly healed during treatment of an urinary tract infection.

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3.) Recurrent acute appendicitis with erythema annulare centrifugum.
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Arch Intern Med 1984 Oct;144(10):2090-2 Related Articles, Books, LinkOut

Sack DM, Carle G, Shama SK

Erythema annulare centrifugum (EAC), a chronic figurate eruption, occurred in a 28-year-old male physician several months following the onset of recurrent abdominal pain. Two months after the manifestation of EAC, another episode of abdominal pain culminated in appendectomy for perforated appendicitis. During his convalescence, the skin lesions faded and did not reappear. We propose that recurrent appendiceal inflammation caused both the episodic pain and the skin eruptions. Additionally EAC may be a sign of chronic infection, internal malignancy, or food allergy. Although truly chronic appendicitis is a disputed entity, recurrent, spontaneously resolving episodes of appendicitis occasionally do precede surgical appendicitis. The presence of EAC in a patient having recurrent abdominal pain should discourage a precipitant diagnosis of functional illness and prompt further investigation.

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4.) Erythema annulare centrifugum, angio-oedema in lupus vulgaris.
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JPMA J Pak Med Assoc 1984 Sep;34(9):276-9

Shabbir SG, Hassan M, Kazmi SA, Jahangir M


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5.) Erythema annulare centrifugum. A case due to tuberculosis.
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Int J Dermatol 1982 Nov;21(9):538-9 Related Articles, Books, LinkOut

Burkhart CG
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6.) [Erythema annulare centrifugum of the legs symptomatic of prostate adenocarcinoma; a specific paraneoplastic syndrome]?
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Ann Dermatol Venereol 1979 Oct;106(10):789-92 Related Articles, Books, LinkOut

[Article in French]

Dupre A, Carrere A, Bonafe JL, Viraben R, Christol B, Lassere J
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7.) Erythema annulare centrifugum and Hodgkin's disease: association with disease activity.
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Arch Intern Med 1979 Apr;139(4):486-7 Related Articles, Books, LinkOut

Leimert JT, Corder MP, Skibba CA, Gingrich RD

The skin lesions of erythema annulare centrifugum developed in a 58-year-old woman who had Hodgkin's disease. Response of the neoplasm to vinblastine sulfate was accompanied by disappearance of the skin lesions. When therapy was discontinued, both disorders recurred, and both responded to reinstitution of vinblastine therapy. To our knowledge, this case is the first reported association of erythema annulare centrifugum and Hodgkin's disease. The cutaneous manifestation in this patient were a nonneoplastic concomitant of her neoplastic disorder.

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8.) On erythema annulare centrifugum-type of psoriasis.
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Acta Derm Venereol Suppl (Stockh) 1979;59
Rajka G, Thune PO

A case of EAC type psoriasis is reported. Routine and immunologic investigations were negative. HLA-B8 was found by typing. Some therapeutic benefit was achieved by combination of retinoid (Ro-10-9359) plus PUVA. According to a review of the literature half of the cases are unconnected to classical psoriasis, whereas the other half is connected and mostly of (periodic) pustular character. The necessity of clinical research in this intermediate type between psoriasis vulgaris and pustulosa is emphasized.

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9.) Annular psoriasiform eruption with lymphocytic
infiltration of the epidermis: a variant of acute psoriasis?
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SO - Dermatology 1992;185(2):156-9
AU - Terunuma A; Takahashi K; Sakakibara A; Aiba S; Tagami H
PT - JOURNAL ARTICLE
AB - Disseminated annular psoriasiform lesions developed over a period of 2 months in a 48-year-old man with no preceding psoriatic history of drug intake, being accompanied by general dullness and arthralgia. Etretinate was effective for both skin eruption and arthralgia; only the latter recurred on its cessation 5 months later. However, histologic features examined by serial sections totally lacked those of pustular psoriasis; there were no neutrophils in the epidermis where massive T lymphocyte infiltration existed instead, in a fashion similar to that of early psoriatic lesions. We differentiated this peculiar annular psoriasiform eruption from the annular erythematous lesions noted in pityriasis rosea, erythema annulare centrifugum, subacute cutaneous lupus erythematosus, annular erythema associated with Sjogren's syndrome and erythema chronicum migrans. It is our speculation that this dermatosis represents a variant of acute psoriasis, rather than annular pustular psoriasis. The histopathologic and immunohistologic findings suggest ongoing cellular immune responses in these lesions where some unknown inhibitory mechanisms might be operative against further production of neutrophil chemotactic factors that usually takes place in psoriatic lesions.

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10.) Psoriasis: odd varieties in the adult.
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Acta Derm Venereol Suppl (Stockh) 1979;87:90-4

Kerl H, Pachinger W

Occasionally we observe particular varieties of psoriasis and in rare cases transitional features with other diseases, which pose problems concerning the differential diagnosis and the nosological classification. This communication deals with the following clinical and histological aspects of psoriasis: 1) Sebopsoriasis. Relationship of psoriasis to pityriasis rubra pilaris. 2) Erythema annulare centrifugum type of psoriasis. 3) Is subcorneal pustular dermatosis an expression of pustular psoriasis? 4) Salient histopathological criteria for the diagnosis of the different atypical forms of psoriasis. 5) Presentation of an unusal case with striated and retiform verrucous psoriasis-like eruptions, which show a relationship to parakeratosis variegata.

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11.) [Localized form of psoriasis of the erythema annulare centrifugum type with pustulation]
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SO - Hautarzt 1984 Jan;35(1):53-5
AU - Zala L; Hunziker T
PT - JOURNAL ARTICLE
AB - We report two cases of localized psoriasis of the erythema anulare centrifugum-type with pustulation. Problems of nosological classification and histological differentiation are discussed.

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12.) [Psoriasis and pustular psoriasis of the erythema annulare centrifugum type (3 cases)].
Bull Soc Fr Dermatol Syphiligr 1966 Jul-Aug;73(4):356-8
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[Article in French]

Degos R, Civatte J, Arrouy M

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13.) Erythema annulare centrifugum induced by molluscum contagiosum.
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Br J Dermatol 1993 Nov;129(5):646-7

Furue M, Akasu R, Ohtake N, Tamaki K

Publication Types:
Letter
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14.) Erythema annulare centrifugum and molluscum contagiosum.
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Arch Dermatol 1978 Dec;114(12):1853

Vasily DB, Bhatia SG

Publication Types:
Letter
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15.) [Hypereosinophilic syndrome. Cutaneous picture of "erythema annulare centrifugum"--comparison with ultrastructural study].
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Med Cutan Ibero Lat Am 1988;16(4):299-304

[Article in Portugese]

Calux MJ, Valente NY, Pires MC, Albertoni Neto DR

Hospital do Servidor Publico Estadual de Sao Paulo.

The authors present the third case in the literature of hypereosinophilic syndrome with "erythema annulare centrifugum" like lesions. Cutaneous manifestations were the first sign of the disease. Laboratory investigation including ultrastructural study of cutaneous lesions. This kind of investigation has been done before in only one instance. Clinical and laboratory features of the case are fully discussed taking into account literature findings.

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16.) [Hypereosinophilic syndrome. Centrifugal annular erythema as an initial manifestation].
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Med Cutan Ibero Lat Am 1978;6(5-6):267-72
[Article in Spanish]

Woscoff A, Dancziger E, Zamparo DI

Several closely related conditions make up the idopathic hypereosinophilic syndrome. This syndrome is characterized by persistent and prolonged eosinophilia. The most frequent lesions are in the hematologic, neurologic and gastrointestinal systems. A case is reported in which the initial complaint was an erythema annulare centrifugum.

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17.) Erythema annulare centrifugum as the presenting sign of the hypereosinophilic syndrome: observations on therapy.
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SO - Cutis 1985 Jan;35(1):53-5
AU - Shelley WB; Shelley ED
PT - JOURNAL ARTICLE
AB - A 79-year-old man with severe generalized pruritus and erythema annulare centrifugum as manifestations of his idiopathic hypereosinophilic syndrome slowly responded to long-term therapy with ketoconazole and dapsone. The skin lesions cleared within one month but the pruritus and eosinophilia required seven full months of therapy.

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18.) [Erythema annulare centrifugum as a symptom in acute myeloid leukemia].
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Z Hautkr 1977 Feb 1;52(3):77-80
[Article in German]

Bonniger F, Happle R

Erythema annulare centrifugum occurred in a 68 year-old women suffering from acute myeloid leukemia. A "paraneoplastic" origin of the skin disease was most probable in this case.
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19.) Annular erythemas in infants associated with autoimmune disorders in their mothers. Report on three cases.
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Dermatologica 1977;154(2):115-27

Hammar H, Ronnerfalt L

Three infant boys with a centrifugal annular erythema mainly consistent with erythema annulare centrifugum, developing a few weeks after birth, are described. The lesions disappeared before the age of 6 months, without atrophy, and during this period the infants were otherwise healthy. This group is considered to belong to one of three types of reactivity in infants associated with or expressed as a connective tissue disease, especially lupus erythematosus, in the mother and child or in either. In type 1, signs and symptoms of systemic lupus erythematosus are or will be present in the mother and the child displays discoid lupus erythematosus lesions at birth or soon after. In type 2, the mother has the same signs and symptoms as in type 1 but the child develops a centrifugal annular erythema 3-6 weeks after birth. In type 3, discoid lupus erythematosus is present at an early stage in the infant, while the mother is healthy. This type may represent an early onset of lupus erythematosus in the infants.

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20.) Ampicillin induced erythema annulare centrifugum.
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J Indian Med Assoc 1975 Dec 1;65(11):307-8

Gupta HL, Sapra SM

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21.) [Specific leukemic infiltration with the appearance of erythema annulare centrifugum (Darier) in chronic lymphadenosis].
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Hautkr 1975 Nov 15;50(22):930-7

[Article in German]

Diem E
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22.) Unusual cutaneous associations of a malignant carcinoid tumour of the bronchus--erythema annulare centrifugum and white banding of the toe nails.
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Br J Dermatol 1975 Sep;93(3):341-5

Everall JD, Dowd PM, Ardalan B

The case history of a patient who presented with erythema annulare centrifugum and white banding of the toe nails is recorded. On investigation for an underlying malignancy the patient was found to have an opacity in the lower lobe of the right lung. Subsequently lobectomy was performed and histology of the operative specimen revealed a malignant carcinoid tumour of the bronchus.

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23.) [The bullous variant of erythema annulare centrifugum Darier in Candida albicans infections].
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Hautarzt 1975 Sep;26(9):466-70

[Article in German]

Kind R

A 15-year old male patient with Down-Syndrome suffering from a unusual vesicular type of erythema annular centrifugum Darier and a concurrent intestinal infection with candida albicans is described. Histology, immunhistological assay, and clinical observation allowed to differentiate Erythema annulare centrifugum from erythema exsudativum multiforme as well as dermatitis herpetiformis. On the basis of immunological findings and the clinical course, a hypersensitivity to candida albicans like a so-called "id-reaction" is assumed to be the main etiological factor in this case.

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24.) [Migrant eruptions in lupus erythematosus. Apropos of a case of lupus erythematosis gyratus repens].
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Ann Dermatol Syphiligr (Paris) 1975;102(5-6):481-9

[Article in French]

Hewitt J, Benveniste M, Kaufmann P, Lessana-Leibowitch M

Rare cases of migrant circinated eruptions occurring during the course of lupus erythematosus have been published so far. They have been classified in two categories: 1) supposed toxicodermias due to antimalarials; 2) real cases of erythema annulare centrifugum, mostly inaugurating the L. E. In an exceptional case, a migrating eruption looking like an erythema annulare with a complicated pattern on the trunk, neck and limbs, took place between two rashes of typical L.E. The exact nature of this eruption, clinically and histologically atypical, and its relation with the L.E. itself, have been discussed.

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25.) Erythema annulare centrifugum coincident with Epstein-Barr virus infection in an infant.
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Acta Paediatr Scand 1974 Sep;63(5):788-92

Hammar H
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26.) Erythema annulare centrifugum and relapsing polychondritis.
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Ann Dermatol Venereol 2000 Aug-Sep;127(8-9):735-9

Ingen-Housz S, Venutolo E, Pinquier L, Cavelier-Balloy B, Dubertret L, Flageul B

Service de Dermatologie 1, Hopital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris Cedex 10.

[Medline record in process]

BACKGROUND: Relapsing polychondritis is a rare systemic disease. Skin involvement occurs in 20 to 50 % of cases. Cutaneous signs are most often related to a leukocytoclastic vasculitis. Association of relapsing polychondritis with neutrophilic dermatosis have also been reported. We report the first case of an erythema annulare centrifugum-like dermatosis associated with relapsing polychondritis, with a two years delay between both conditions. CASE REPORT: A 74 year-old man was seen for papulo-erythematous centrifugal annular lesions that appeared 18 months earlier in a context of bad general conditions. Biological tests were normal. Several skin biopsies were performed, showing at the beginning features of drug reaction and then of lupus-lichen. Treatment with hydroxychloroquine, topical corticosteroids, dapsone and thalidomide were unsuccessful. In the following months, the patient developed fever and relapsing bronchitis. Suddenly, a chondritis of the ears appeared, leading to the diagnosis of relapsing polychondritis. All the cutaneous, chondritic and respiratory signs disappeared with oral steroid therapy. Two years after the diagnosis of relapsing polychondritis the patient developed refractory anemia. DISCUSSION: Cutaneous signs of relapsing polychondritis are frequent and may occur several months or years before the chondritis. They are polymorphous, but to the best of our knowledge, a clinical aspect of erythema annulare centrifugum has never been described. Our observation recalls the sometimes long delay between the cutaneous and the chondritic signs of relapsing polychondritis and the high frequency of dysmyelopoiesis in relapsing polychondritis with cutaneous involvement.

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27.) Vulvar disease in children: a clinical audit of 130 cases.
============================================================
Pediatr Dermatol 2000 Jan-Feb;17(1):1-6

Fischer G, Rogers M

Department of Dermatology, Royal Alexandra Hospital for Children, Westmead, Australia.

We evaluated 130 prepubertal girls presenting with a vulvar complaint to determine the spectrum and frequency of conditions seen in this age group. Of the patients, 41 (33%) had atopic or irritant dermatitis, 23 (18%) had lichen sclerosus, 21 (17%) had psoriasis, 15 (12%) had vulvar lesions, most often hemangiomas and nevi, and 13 (10%) had streptococcal vulvovaginitis. Diagnoses less frequently seen were staphylococcal folliculitis (four patients), labial fusion (three patients), genital warts (two patients), molluscum contagiosum of the vulva only (one patient), vulvar bullous pemphigoid (two patients), scabies nodules (one patient), erythema annulare centrifugum (one patient), tinea (two patients), and vitiligo (one patient). We also encountered vulvar presentations of systemic diseases (varicella, staphylococcal scalded skin syndrome, and Henoch-Schonlein purpura, all one patient each). We did not see candidal vulvovaginitis in this age group nor did we encounter bacterial infection with pathogens other than Staphylococcus aureus and S. pyogenes.

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28.) Amitriptyline-induced erythema annulare centrifugum.
============================================================
Cutis 1999 Jan;63(1):35-6

Garcia-Doval I, Peteiro C, Toribio J

Department of Dermatology, General Hospital of Galicia, Faculty of Medicine, Santiago de Compostela, Spain.

A case of amitriptyline-induced superficial erythema annulare centrifugum (EAC) is reported. Its singular characteristics are prominent epidermal manifestations, with clinical and histologic vesiculation, associated with vacuolar degeneration at the dermoepidermal junction; numerous arciform lesions, accompanied by diffuse erythema on rechallenge; quick change, more rapid than that usually described for EAC; and a short course, in contrast with the usual chronic evolution of EAC. To our knowledge, this is the first reported case of EAC associated with amitriptyline intake.

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29.) Drugs causing fixed eruptions: a study of 450 cases.
============================================================
Int J Dermatol 1998 Nov;37(11):833-8

Mahboob A, Haroon TS

Department of Dermatology, King Edward Medical College/Mayo Hospital, Lahore, Pakistan.

BACKGROUND: Drug eruptions are among the most common cutaneous disorders encountered by the dermatologist. Some drug eruptions, although trivial, may cause cosmetic embarrassment and fixed drug eruption (FDE) is one of them. The diagnostic hallmark is its recurrence at previously affected sites. OBJECTIVE: We evaluated 450 FDE patients to determine the causative drugs. RESULTS: The ratio of men to women was 1:1.1. The main presentation of FDE was circular hyperpigmented lesion. Less commonly FDE presented as: nonpigmenting erythema, urticaria, dermatitis, periorbital or generalized hypermelanosis. Occasionally FDE mimicked lichen planus, erythema multiforme, Stevens-Johnson syndrome, paronychia, cheilitis, psoriasis, housewife's dermatitis, melasma, lichen planus actinicus, discoid lupus erythematosus, erythema annulare centrifugum, pemphigus vulgaris, chilblains, pityriasis rosea and vulval or perianal hypermelanosis. Cotrimoxazole was the most common cause of FDE. Other drugs incriminated were tetracycline, metamizole, phenylbutazone, paracetamol, acetylsalicylic acid, mefenamic acid, metronidazole, tinidazole, chlormezanone, amoxycillin, ampicillin, erythromycin, belladonna, griseofulvin, phenobarbitone, diclofenac sodium, indomethacin, ibuprofen, diflunisal, pyrantel pamoate, clindamycin, allopurinol, orphenadrine, and albendazole. CONCLUSIONS: Cotrimoxazole was the most common cause of FDE, whereas FDE with diclofenac sodium, pyrantel pamoate, clindamycin, and albendazole were reported for the first time. FDE may have multiform presentations.

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30.) Erythema annulare centrifugum in a patient with polyglandular autoimmune disease type 1.
============================================================
Cutis 1998 Nov;62(5):231-2

Garty B

Kipper Institute of Pediatric Immunology, Department of Pediatrics A, Schneider Children's Medical Center of Israel, Petah Tiqva.

The dermatologic disorders in polyglandular autoimmune disease (PGAD) type 1 (previously called chronic mucocutaneous candidiasis) are nail dystrophy, vitiligo, and alopecia. A patient with PGAD and erythema annulare centrifugum (EAC) is presented. This association has not been reported previously. EAC may be related to occult or low-grade Candida infection in PGAD.

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31.) Recurrent ringed lesion of the sole: erythema annulare centrifugum.
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J Am Podiatr Med Assoc 1998 Mar;88(3):144-5

Lemont H, Garber R, Ortenzi J

Publication Types:
Letter
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32.) Erythema annulare centrifugum associated with pregnancy.
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Acta Derm Venereol 1998 May;78(3):237-8

Choonhakarn C, Seramethakun P

Publication Types:
Letter
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33.) [Annular erythema in childhood--a new eosinophilic dermatosis].
============================================================
Hautarzt 1998 Feb;49(2):131-4
[Article in German]

Kunz M, Hamm K, Brocker EB, Hamm H

Klinik und Poliklinik fur Haut- und Geschlechtskrankheiten, Universitat Wurzburg.

Annular erythema of infancy is a rare and little-known entity. Since its initial description by Peterson and Jarratt in 1981 only 4 further cases have been reported. We present the first case in the German literature. A 4-year-old boy developed non-itching erythematous papules on the trunk which evolved into annular and gyrate erythemas within weeks. The condition showed a relapsing course with disease-free intervals of several months duration. There were no general complaints. Laboratory investigations including detailed serological tests for infectious diseases were normal. Histopathology showed a striking eosinophilic inflammatory infiltrate predominantly in perivascular areas, without peripheral blood eosinophilia. The clinical differential diagnosis of annular erythema of infancy includes erythema annulare centrifugum, while microscopically one must exclude eosinophilic cellulitis (Wells' syndrome). The etiology is unknown and there is no effective therapy. In our case, as well as in all previously published cases, the disease resolved spontaneously. Therefore, it may be considered benign and self-limited.

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34.) Erythema annulare centrifugum and intestinal Candida albicans infection--coincidence or connection?
============================================================
Acta Derm Venereol 1997 Jan;77(1):93-4

Schmid MH, Wollenberg A, Sander CA, Bieber T

Publication Types:
Letter
============================================================

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35.) Dermacase. Erythema annulare centrifugum.
============================================================
Can Fam Physician 1996 Nov;42:2148, 2151 Related Articles, Books, LinkOut

Enta T

University of Calgary.
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============================================================
36.) Psoriasis: changing clinical patterns.
============================================================
Australas J Dermatol 1996 May;37 Suppl 1:S27-9 Related Articles, Books, LinkOut

Rotstein H

Department of Dermatology, St Vincent's Hospital, Melbourne, Victoria, Australia.

Although psoriasis has been recognized at least since Biblical times new forms, associations and influences continue to be described in the twentieth century. New forms include the rupioid erythema annulare centrifugum-like and follicular patterns. Associations with vitiligo bullous pemphigoid and lupus erythematosus have been recently described. Endoscopic surgery has increased para umbilical psoriasis while Sun Smart campaign have reduced photo-aggravated psoriasis. Infections such as paediatric perianal streptococcal cellulitis and drugs including angiotensin converting enzyme inhibitors and cytokines exacerbate psoriasis.

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37.) Erythema annulare centrifugum and Escherichia coli urinary infection.
============================================================
Lancet 1996 Mar 30;347(9005):897-8

Borbujo J, de Miguel C, Lopez A, de Lucas R, Casado M

Publication Types:
Letter
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38.) Sarcoidosis presenting as erythema annulare centrifugum.
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Clin Exp Dermatol 1995 Nov;20(6):502-3

Altomare GF, Capella GL, Frigerio E

Instituto di Dermatologia, Ospedale Maggiore IRCCS, Universita degli Studi di Milano, Italy.

Erythema annulare centrifugum (EAC), a disease belonging to the poorly characterized category of 'figurate erythemas', has been associated with a variety of conditions, such as connective tissue diseases, infections, neoplasms and drug reactions. Here we report a case of EAC associated with sarcoidosis, the first case in the literature to our knowledge. EAC was the sole sign of the granulomatous disease process, which was diagnosed by means of appropriate investigations only after the patient reported the sudden resolution of a long-standing sensitization to perfumes and parabens. Steroid treatment for sarcoidosis improved the patient's condition, and restored the allergic response to these substances.

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39.) [Recurrent annular erythema--cutaneous manifestation of Sjogren syndrome with anti SS-A (Ro) and anti SS-B (La) antibodies].
============================================================
Nippon Rinsho 1995 Oct;53(10):2557-62

[Article in Japanese]

Usuda T

Division of Dermatology, Social Insurance Chukyo Hospital.

Eight cases of Sjogren syndrome (SjS) with anti-SS-A and anti-SS-B antibodies are reported. They developed erythema annulare centrifugum-like annular erythema which mainly appeared on the face. Laboratory tests showed similar serologic changes. RA factor, speckled type antinuclear antibody, anti SS-A & SS-B antibodies (DID & ELISA) were observed but complements and anti-double stranded DNA antibodies were not detected. In spite of mild sicca symptoms, sialogram, lip biopsy, Shirmer test and Rose Bengal staining showed typical changes of SjS. It is considered that the recurrent annular erythema is a specific skin manifestation of SjS with anti SS-A/SS-B antibodies.

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40.) Non-small-cell lung cancer with multiple paraneoplastic syndromes.
============================================================
Eur Respir J 1995 Jul;8(7):1231-4

Monsieur I, Meysman M, Noppen M, de Greve J, Delhove O, Velckeniers B, Jacobvitz D, Vincken W

Dept of Internal Medicine, Academic Hospital, University of Brussels (AZ-VUB), Belgium.

We describe the case of a patient with multiple paraneoplastic syndromes, six in total, associated with a non-small-cell cancer of the lung. In this single patient we found hypertrophic pulmonary osteoarthropathy, hyperkeratosis of palms and soles, erythema annulare centrifugum, syndrome of inappropriate secretion of antidiuretic hormone (SIADH), and ectopic andrenocorticotrophic hormone (ACTH) and calcitonin production.

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41.) [Darier's erythema annulare centrifugum of neonatal onset with a 15 years' follow-up. Efficacy of interferon and role of cytokines].
============================================================
Ann Dermatol Venereol 1995;122(6-7):422-6

[Article in French]

Guillet MH, Dorval JC, Larregue M, Guillet G

Service de Dermatologie, CHU Brest

INTRODUCTION. Darier's erythema annulare centrifugum (EAC) is a disease of unknown etiology. Some observations of EAC in infancy suggest a better prognosis for early EA. The observations presented herein gives different information regarding prognosis and pathogenesis. OBSERVATION. A child presents with typical lesions of EAC from early infancy up to the age of 15 years. Laboratory data are normal. Similar lesions were locally reproduced by intradermal injection by candidine but antifungal drugs were unsuccessful. Many antiinflammatory treatments failed to improve the disease. Because of the improvement during hyperthermic episodes, a treatment by subcutaneous interferon alpha (2 millions U 3 times a week) was given for six months with a dramatic success (with seric increase of TNF alpha and IL2) DISCUSSION. The long term duration of EAC suggests that EA of infancy may represent the early beginning of Darier's EAC. The efficacy of interferon suggests that cytokines are involved in the pathogenesis of EAC.

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42.) Erythema annulare centrifugum unresponsive to immunosuppressive therapy.
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Br J Dermatol 1994 Oct;131(4):587

Phillips WG, Ramsay ID, Breathnach SM

Publication Types:
Letter
============================================================

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43.) Annular vasculitis associated with pregnancy.
============================================================
Br J Dermatol 1993 Nov;129(5):599-601

Kelly RI, Cook MG, Marsden RA

Department of Dermatology, St George's Hospital, London, U.K.

A 29-year-old woman presented in the 31st week of pregnancy with an unusual bilateral, erythematous eruption on the posterior calves, which clinically resembled erythema annulare centrifugum. A biopsy showed features of a mild leucocytoclastic vasculitis. Within 2 days of delivery the rash had almost resolved, suggesting that its activity was related to the pregnancy. The diagnosis is consistent with 'annular vasculitis', which we suggest represents a distinct variant of leucocytoclastic vasculitis, and a distinct clinicopathological entity. We are not aware of any previous reports of an association between annular vasculitis and pregnancy.

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44.) Inflammatory carcinoma masquerading as erythema annulare centrifugum.
============================================================
Acta Derm Venereol 1993 Apr;73(2):138-40

Reichel M, Wheeland RG

Department of Dermatology, University of California, Davis, Sacramento 95816.

A case of inflammatory carcinoma, or carcinoma erysipelatodes, clinically resembling erythema annulare centrifugum is reported. The cutaneous inflammatory carcinoma was due to metastasis by a signet-ring cell adenocarcinoma, probably of gastrointestinal origin. This is the third reported case of inflammatory carcinoma with signet-ring cell infiltration. Cancer patients with atypical or unusual inflammatory dermatoses should be evaluated by skin biopsy because of the possible association with the internal neoplastic process.

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45.) [Darier's erythema annulare centrifugum and primary Vaquez polycythemia]
============================================================
SO - Ann Dermatol Venereol 1984;111(8):767-8
AU - Triller R; Renard T; de Lacharriere O; Leonard F; Caulet T; Kalis B
PT - JOURNAL ARTICLE
============================================================


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46.) Recurrent annular erythema with anti-SSA/Ro and anti-SSB/La antibodies localized on palms and fingers in an elderly man.
============================================================
SO - Lupus 1994 Feb;3(1):65-7
AU - Satoh M; Ajmani AK; Yamagata H; Okubo K; Akizuki M
PT - JOURNAL ARTICLE
AB - A 69-year-old Japanese man with recurrent annular erythema localized on palms and flexor surface of fingers with anti-SSA/Ro and anti-SSB/La antibodies, is reported. The present case indicates that even in an elderly man with atypical localization, annular erythema with autoimmunity may be considered and serological analysis should be performed. Systematic studies will be required to understand the relationship between 'recurrent annular erythema associated with anti-SSB/La antibodies' in Japanese, subacute cutaneous lupus erythematosus (SCLE) and 'annular erythema associated with Sjogren's syndrome'.

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47.) Clinical and immunological analysis of annular erythema associated with Sjogren syndrome.
============================================================
SO - Dermatology 1994;189 Suppl 1:14-7
AU - Katayama I; Yamamoto T; Otoyama K; Matsunaga T; Nishioka K
PT - JOURNAL ARTICLE
AB - Clinical and immunopathological analysis was performed on 24 cases of Sjogren syndrome with annular erythema (AESjS). AESjS predominantly appears on the cheek of the face where skin temperature is relatively low in comparison with other sites. VCAM-1 and ICAM-1 were strongly expressed on endothelial cells of AESjS, while epidermal expression of ICAM-1 was focal and weak. VCAM-1 mRNA expression was also much more intense compared to systemic lupus erythematosus. The lymphocyte response to staphylococcal enterotoxin B was higher in AESjS than that of controls, and cells positive for T cell receptor V beta 6,9,12 were expanded after the culture. Superantigen-driven endothelial-cell-dependent T cell infiltration to the skin plays a crucial role in AESjS.

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48.) Clinical, serological and immunogenetic features of Japanese anti-Ro/SS-A-positive patients with annular erythema.
============================================================
SO - Dermatology 1994;189 Suppl 1:11-3
AU - Miyagawa S
PT - JOURNAL ARTICLE
AB - Sixteen anti-Ro/SS-A-positive patients with recurrent annular erythema, which has recently been recognized as a unique cutaneous manifestation of Sjogren's syndrome, were studied. Eight of the 16 patients met the American Rheumatism Association criteria for systemic lupus erythematosus. Fifteen patients had anti-La/SS-B antibodies. Antibodies against U1RNP were detected in 2 patients with systemic lupus erythematosus, 1 with anti-Sm antibodies. Patterns of autoimmune response to Ro/SS-A antigens were variable by immunoblot analysis. HLA typing by the standard complement-dependent microcytotoxicity assay revealed that all the 16 patients were positive for HLA-DRw52 antigens but negative for either HLA-B8 or HLA-DR3 which is reportedly associated with the autoimmune response to Ro/SS-A antigens in white and black patients.

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49.) Persistent annular erythema of infancy.
============================================================
SO - Pediatr Dermatol 1993 Mar;10(1):46-8
AU - Helm TN; Bass J; Chang LW; Bergfeld WF
PT - JOURNAL ARTICLE
AB - Annular erythema of infancy is an uncommon, nonpruritic, figurate erythema that begins in the first year of life. Biopsy specimens reveal a perivascular and interstitial lymphocytic infiltrate with numerous eosinophils. The cause of the disorder is unknown, but a hypersensitivity response to unrecognized antigens is suspected. The disorder is self-limited, but may last for many months. In our patient the eruption continued 19 months after its onset.

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50.) HLA antigens in anti-Ro(SS-A)-positive patients with recurrent annular erythema.
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SO - J Am Acad Dermatol 1993 Feb;28(2 Pt 1):185-8
AU - Miyagawa S; Dohi K; Shima H; Shirai T
PT - JOURNAL ARTICLE
AB - BACKGROUND: Recurrent annular erythema associated with the anti-Ro(SS-A) antibody response has recently been reported in Orientals. The association is assumed to represent a distinct clinical entity. OBJECTIVE: Our purpose was to extend knowledge on the immunogenetic spectrum of the disease. METHODS: Sixteen anti-Ro(SS-A)-positive Japanese patients with recurrent annular erythema and Sjogren's syndrome were studied. The standard complement-dependent microcytotoxicity assay was used to type the HLA-A, -B, -C, -DR, and -DQ, as well as the HLA-DRw52 and -DRw53 antigens. RESULTS: All 16 patients were positive for HLA-DRw52 antigens as compared with 52% of control subjects (p 0.01 relative risk 14.8). No significant deviations were noted in the phenotype frequencies for HLA-A, -B, -C, and -DQ antigens. CONCLUSION: HLA-DRw52 is closely related to annular erythema in anti-Ro(SS-A)-positive Japanese patients with Sjogren's syndrome.

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51.) Urticated annular erythema: a new manifestation of Sjogren's syndrome.
============================================================
SO - Clin Exp Dermatol 1993 Jan;18(1):50-1
AU - Ostlere LS; Harris D; Rustin MH
PT - JOURNAL ARTICLE
AB - A patient with a unique urticated annular erythema associated with Sjogren's syndrome and some features of systemic lupus erythematosus (SLE) is reported. There has been one previous report of a similar eruption occurring in a patient with Sjogren's syndrome.

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52.) Recurrent annular erythema associated with anti-SS-============================================================
B/La antibodies: analysis of the disease-specific epitope.
SO - Br J Dermatol 1992 Dec;127(6):608-13
AU - Hoshino Y; Hashimoto T; Mimori T; Akizuki M; Nishikawa T
PT - JOURNAL ARTICLE
AB - We have found that anti-SS-B/La antibodies are present in a group of patients with a characteristic recurrent annular erythema, and immunological abnormalities. The presence of a disease-specific epitope for this entity has been examined by comparing immunological reactivity of anti-SS-B/La antibodies between these patients and patients with classical Sjogren's syndrome who have anti-SS-B/La antibodies but do not have this characteristic erythema. In immunoblotting using three different antigen sources, all the sera from both groups exhibited the same reaction patterns. V8 protease mapping showed that the sera could be divided into three groups by the difference in reactivity to two main digested peptide fragments. However, no significant relationship of the reactivity in peptide mapping between the two patient groups was observed. Further studies are necessary to elucidate the role of anti-SS-B/La antibodies in disease pathogenesis in these patients, in particular by more precise peptide mapping using recombinant SS-B/La antigen proteins.

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53.) Erythema annulare centrifugum associated with gold sodium thiomalate therapy.
============================================================
SO - J Am Acad Dermatol 1992 Aug;27(2 Pt 2):284-7
AU - Tsuji T; Nishimura M; Kimura S
PT - JOURNAL ARTICLE
AB - Two women with rheumatoid arthritis developed erythema annulare centrifugum while receiving gold thiomalate therapy. Both patients had similar clinical and histologic findings. Results of a lymphocyte stimulation test were positive in one patient but not in the other.

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54.) Annular erythema. A comparative study of Sjogren syndrome with subacute cutaneous lupus erythematosus.
============================================================
SO - Int J Dermatol 1991 Sep;30(9):635-9
AU - Katayama I; Teramoto N; Arai H; Nishioka K; Nishiyama S
PT - JOURNAL ARTICLE
AB - Annular erythema developed in 22 patients with Sjogren syndrome. Clinically, the annular erythema was subdivided into three forms: Sweet disease-like annular erythema with an elevated border (14 cases); subacute cutaneous lupus erythematosus (SCLE)-like marginally scaled erythema (5 cases); and papular erythema (3 cases). Histopathologically, features commonly seen in annular erythema are deep perivascular and/or periappendageal infiltration of the lymphocytes with an admixture of neutrophils or plasma cells and less frequent epidermal changes suggestive of cutaneous lupus erythematosus. Immunoglobulin or complement deposition along the dermoepidermal junction of lesional skin was observed in 8 of 18 cases, and most of the dermal infiltrates consisted of CD4(+), 4B4(+) cells. The appearance of anti-SS-A(Ro) (100%) and anti-SS-B(La) (77%) was significantly higher in patients with annular erythema. These results suggest that patients with Sjogren syndrome might have a distinct annular erythematous lesion that is both clinically and histopathologically different from SCLE, although close immunologic abnormalities exist in these two diseases.

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55.) Annular erythema associated with Sjogren's syndrome: a variant of systemic lupus erythematosus [see comments]
============================================================
SO - J Am Acad Dermatol 1991 Sep;25(3):557-60
AU - Ruzicka T; Faes J; Bergner T; Peter RU; Braun-Falco O
PT - COMMENT; JOURNAL ARTICLE
AB - We present a Burmese patient with widespread annular erythema associated with Sjogren's syndrome. Unlike previously described cases, the disease occurred in the setting of systemic lupus erythematosus. Photoprovocation testing revealed light sensitivity in the UVA range with elicitation of subacute cutaneous lupus erythematosus-like lesions. The presence of an erythema annulare centrifugum-like eruption should initiate the search for Sjogren's syndrome and systemic lupus erythematosus.

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56.) Lymphocyte response to staphylococcal enterotoxin B in patients with annular erythema associated with Sjogren syndrome.
============================================================
SO - J Dermatol 1991 Feb;18(2):63-8
AU - Katayama I; Asai T; Nishiyama S; Nishioka K
PT - JOURNAL ARTICLE
AB - Lymphocyte response to staphylococcal enterotoxin B (SEB) was analysed in 11 cases with Sjogren syndrome (SjS) who developed annular erythema during the course. Increased lymphocyte response against SEB was observed on day 5 in those patients who developed annular erythema at the time of examination. A similar reaction pattern was observed when Con A and PWM, but not protein A, were used as the mitogen. No significant lymphocyte response was observed in the patients in the inactive stage without annular erythema or in normal controls. Furthermore, peripheral blood lymphocytes express LFA-1 after SEB stimulation. These results suggest that lymphocytes from SjS patients react to various types of antigenic or mitogenic stimulation and that they express cell adhesion molecules, especially in patients with active annular erythema.

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57.) ICAM-1 and LFA-1 expressions in the lesional skin of annular erythema associated with Sjogren syndrome.
============================================================
SO - J Dermatol 1990 Dec;17(12):719-23
AU - Katayama I; Asai T; Nishiyama S; Nishioka K
PT - JOURNAL ARTICLE
AB - ICAM-1 and LFA-1 expression was studied in the lesional skin of ten cases of annular erythema associated with Sjogren syndrome. Most of the infiltrating mononuclear cells around blood vessels expressed LFA-1 in addition to its strong expression on vascular endothelial cells and focal expression on the epidermal basal cell layer in 3 cases. ICAM-1 expression on vascular endothelial cells was similar to LFA-1, although relatively focal and weak expression was observed on mononuclear cells. ICAM-1 expression on keratinocytes was focal and limited to the basal cell layer in annular erythema. These findings suggest that strong expression of ICAM-1 on endothelial cells but not keratinocytes and LFA-1 on mononuclear cells might play some role in the induction of skin lesions in annular erythema associated with Sjogren syndrome.

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58.) Annular erythema associated with primary Sjogren syndrome: analysis of T cell subsets in cutaneous infiltrates [see comments]
============================================================
SO - J Am Acad Dermatol 1989 Dec;21(6):1218-21
AU - Katayama I; Asai T; Nishioka K; Nishiyama S
PT - JOURNAL ARTICLE
AB - Immunohistochemical analysis was performed on the annular erythema associated with Sjogren syndrome. This type of annular erythema is characterized by a doughnutlike appearance with an elevated border and central pallor; it is distinct from subacute cutaneous lupus erythematosus. Histologically this erythema is characterized by coat sleeve-like infiltration of lymphocytes around blood vessels and by nuclear debris in the connective tissue. Vasculitis or epidermal changes suggestive of lupus erythematosus were not observed in any of the cases, although immunoglobulin or complement deposition along the basement membrane zone and focal liquefaction degeneration of the basal layer in involved skin were seen in some cases. Major dermal infiltrates consisted primarily of CD4+ and 4B4+ lymphocytes.

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59.) Annular erythema in identical twins.
============================================================
SO - Cutis 1989 Aug;44(2):139-40
AU - Watsky KL; Hansen T
PT - JOURNAL ARTICLE
AB - A case of superficial gyrate erythema that was indistinguishable from erythema annulare centrifugum occurred in identical twins. We propose to include a familial cause among the known causes of erythema annulare centrifugum rather than considering this a separate entity, "familial annular erythema."

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60.) Annular erythema: a possible association with primary Sjogren's syndrome.
============================================================
SO - J Am Acad Dermatol 1989 Apr;20(4):596-601
AU - Teramoto N; Katayama I; Arai H; Eto H; Kamimura K; Uetsuka M; Kondo S; Nishioka K; Nishiyama S
PT - JOURNAL ARTICLE
AB - In four patients with primary Sjogren's syndrome a distinct annular erythema developed, which was characterized by a wide, elevated border (which can be likened to a doughnut ring) and central pallor. Histologically, there was a coat sleeve-like infiltration of lymphocytes around blood vessels and nuclear debris in the connective tissue. Vasculitis or epidermal changes suggestive of lupus erythematosus were not observed, and there was no immunoglobulin deposition along the basement membrane zone. This annular erythema may be a cutaneous manifestation of Sjogren's syndrome.

============================================================
61.) Neonatal lupus syndrome and microtubular structure.
============================================================
SO - J Dermatol 1989 Feb;16(1):54-8
AU - Nitta Y; Ohashi M
PT - JOURNAL ARTICLE
AB - A female infant, at 6 weeks old, with the clinical manifestation of annular erythemas on the trunk and face, was positive for anti-SS-A and anti-SS-B antibodies. The annular erythema disappeared spontaneously at the age of 7 months when anti-SS-A and anti-SS-B antibodies were negative. Electron microscopic observation of the vascular endothelial cells on the annular erythema revealed microtubular structures. Later microtubular structures were found absent from the vascular endothelial cells of the area where the annular erythema had disappeared. The patient's mother is suffering from Sjogren's syndrome; she has no clinical symptoms but anti-SS-A and anti-SS-B antibodies are positive and a biopsy of small salivary glands of the lip demonstrated a marked periductal mononuclear cell infiltration. Microtubular structures were observed in her vascular endothelial cells in the small salivary gland region. These findings suggest that disappearance of microtubular structure may have some relationship with anti-SS-A and anti-SS-B antibodies.

============================================================
62.) Erythema annulare of infancy.
============================================================
SO - Cutis 1988 Oct;42(4):353-5
AU - Metzker A; Frumkin A
PT - JOURNAL ARTICLE
AB - A case of erythema annulare of infancy lasting for two years is presented. The striking features of this overall annular eruption, of idiopathic origin, are noted. This case is unusual because of the late onset and the long duration of symptoms. Such cases warrant prolonged follow-up examinations after the annular lesions disappear.

============================================================
63.) An annular erythema of infancy.
============================================================
SO - Arch Dermatol 1987 Apr;123(4):510-3
AU - Cox NH; McQueen A; Evans TJ; Morley WN
PT - JOURNAL ARTICLE
AB - An unusual annular and arciform erythema in an infant is reported. Skin lesions appeared when the child was 4 days old, and multiple lesions have been present during the subsequent two years. Individual lesions gradually enlarge over a period of a few weeks, and they resolve spontaneously without any residual cutaneous abnormality. This annular erythema is clinically and histologically distinct from previously described annular erythemas of infancy, with which it is compared.

============================================================
64.)Reactive annular erythema after intramuscular vitamin K.
============================================================
SO - Cutis 1986 Jun;37(6):445-8
AU - Kay MH; Duvic M
PT - JOURNAL ARTICLE
AB - We present a case of a 70-year-old woman who received multiple intramuscular vitamin K injections before undergoing an invasive diagnostic procedure. Four weeks later she noted enlarging annular erythematous plaques at the sites of each injection. Although this occurrence has been recognized in the European literature, it either occurs less frequently in the United States or is not commonly reported. This is the second case report in the English literature.

============================================================
65.) Annular erythema of infancy.
============================================================
SO - J Am Acad Dermatol 1986 Feb;14(2 Pt 2):339-43
AU - Hebert AA; Esterly NB
PT - JOURNAL ARTICLE
AB - An urticarial annular erythema began in our patient at 6 weeks of age and resolved completely by 14 months of age. Individual lesions lasted 2 to several days and tended to erupt in cycles, with each cycle lasting 5 to 6 weeks. The lesions were totally asymptomatic and left no residual scaling or hyperpigmentation. Histologically, a dense perivascular infiltrate of lymphocytes, histiocytes, eosinophils, and a few plasma cells was evident. The clinical appearance, course, and histologic characteristics resemble closely the case reported by Peterson and Jarratt in 1981.

============================================================
66.) [Erythema annulare centrifugum revealing linear IgA dermatitis of childhood]
============================================================
SO - Ann Dermatol Venereol 1986;113(12):1213-22
AU - Larregue M; Bressieux JM; Laidet B; Cavaroc Y; Gallet P; de Giacomoni P; Touchard G
PT - JOURNAL ARTICLE
AB - Linear IgA dermatitis was diagnosed in a 13-year old girl with erythema annulare centrifugum (EAC) on the basis of the criteria laid down by Jablonska: vesiculo-bullous eruption with specific patterns on subsequent flare-ups, subepidermal vesicles and bullae with papillary eosinophilic abscesses in erythematous areas, positive linear IgA antibody response at direct immunofluorescence in the lamina basal, absence of intolerance to gluten and responsiveness to sulfapyridine and dapsone. This patient was followed up for 10 years. During the first 5 years any attempt at withdrawing dapsone resulted in quick relapse which always remained responsive to that drug. After 5 years discontinuing dapsone was no longer followed by relapse, and the girl was considered clinically cured. Yet direct immunofluorescence in healthy skin remained positive for 2 years after treatment was stopped, as has previously been reported. At the age of 23, after 5 years without treatment the patient remained cured. This case demonstrates that linear IgA dermatitis is one of the causes of EAC. Autoimmune bullous diseases, such as pemphigus with eosinophilic spongiosis, bullous pemphigoid and dermatitis herpetiformis, are known to present as EAC. Direct cutaneous immunofluorescence is necessary to the aetiological diagnosis of EAC.

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67.) Erythema annulare centrifugum: an unusual case due to hydroxychloroquine sulfate.
============================================================
SO - Cutis 1985 Aug;36(2):129-30
AU - Hudson LD
PT - JOURNAL ARTICLE
AB - Erythema annulare centrifugum presents as a cutaneous hypersensitivity to diverse causes including fungal and yeast infections, parasitic infestations, drugs, and, rarely, occult malignancies. A prolonged case of erythema annulare centrifugum secondary to the use of hydroxychloroquine sulfate is presented. The prolonged time needed for clearing after discontinuation of the medication is thought to result from the melanocyte-binding characteristics of the drug.

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68.) 'Persistent' annular erythema of infancy.
============================================================
SO - Arch Dermatol 1984 Aug;120(8):1069-72
AU - Toonstra J; de Wit RF
PT - JOURNAL ARTICLE
AB - An unusual annular erythema occurred in a 6-month-old girl. Recurrent annular lesions appeared on the face and back, but annular lesions persisted for ten months on the distal extremities. Eleven months after the eruption appeared, it resolved completely without recurrence. This seemingly unique condition is compared with other cases of chronic annular erythemas, especially those previously described as erythema gyratum perstans.

============================================================
69.) Erythema annulare centrifugum associated with ascariasis.
============================================================
SO - Arch Dermatol 1981 Sep;117(9):582-5
AU - Hendricks AA; Lu C; Elfenbein GJ; Hussain R
PT - JOURNAL ARTICLE
AB - Erythema annulare centrifugum (EAC) is a figurate erythema that has been associated with man diverse entities. A case of EAC was related to infestation by the nematode, Ascaris lumbricoides. A careful examination of the patient did not define an immunologic basis for EAC. Results of lymphocyte stimulation tests of the patient showed an immune response to A lumbricoides extracts but not to A suum extracts. This finding is of practical importance, since most laboratoires use A suum extracts in routine skin and serologic tests for human ascariasis.

============================================================
70.) Annular erythema of infancy.
============================================================
SO - Arch Dermatol 1981 Mar;117(3):145-8
AU - Peterson AO Jr; Jarratt M
PT - JOURNAL ARTICLE
AB - The lesions of an unusual annular erythema in an infant evolved from erythematous papules, to rings, to interrupted arcs over 36 to 48 hours, and then resolved without a trace. New lesions appeared and evolved with remarkable uniformity for eight months and then disappeared. This seemingly unique eruption is compared with other annular erythemas described in infants.

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71.) Annular erythema as an unusual manifestation of chronic disseminated lupus erythematosus.
============================================================
SO - Arch Dermatol 1980 Apr;116(4):450-3
AU - Maciejewski W
PT - JOURNAL ARTICLE
AB - Numerous annular erythematous lesions developed in a 47-year-old woman, involving most of the integument. Thorough clinical, histopathologic, and immunopathologic investigations confirmed the diagnosis of lupus erythematosus. Unusual clinical, histologic, and immunofluorescence microscopy patterns emerged during the course of the disease, which was resistant to treatment.

============================================================
72.) Multiple annular erythema [letter]
============================================================
SO - J Dermatol 1994 Sep;21(9):699-700
AU - Miyoshi H; Kanzaki T
PT - LETTER
============================================================

============================================================
73.) Reactive erythemas: erythema annulare centrifugum and erythema gyratum repens.
============================================================
SO - Clin Dermatol 1993 Jan-Mar;11(1):135-9
AU - Tyring SK
PT - JOURNAL ARTICLE; REVIEW (57 references); REVIEW, TUTORIAL
============================================================

============================================================
74.) [Squamous erythema annulare centrifugum]
============================================================
SO - Ann Dermatol Venereol 1993;120(3):237-40
AU - Petit A; Nahmias M; Gaulier A; Sigal-Nahum M; Ruzniewsky P; Belaich S
PT - JOURNAL ARTICLE
AB - A case of squamous erythema annulare centrifugum has been observed. It was characterized by striking clinical features and peculiar histological findings, including necrosis of keratinocytes. A search for causative factors was negative. Treatment with tar ointment (Brocq) rapidly resulted in dramatic healing of the lesions; however, the usual features of annular psoriasis were absent in our case.

============================================================
75.) Annular erythema associated with Sjogren's syndrome [letter; comment]
============================================================
SO - J Am Acad Dermatol 1992 Aug;27(2 Pt 1):276
AU - Katayama I; Teramoto N; Arai H; Nishiyama S; Nishioka K
PT - COMMENT; LETTER
============================================================

============================================================
76.) An intensive care unit nurse with a recurring annular lesion. Erythema annulare centrifugum (EAC).
============================================================
SO - Arch Dermatol 1992 Jul;128(7):977, 980
AU - Janss G; Schmidt K; Gattuso P; Massa M; Welykyj S
PT - JOURNAL ARTICLE
============================================================

============================================================
77.) Erythema annular centrifugum in Q fever.
============================================================
SO - Int J Dermatol 1991 Jul;30(7):502
AU - Betlloch I; Amador C; Chiner E; Varona C; Carbonell C; Vilar A
PT - JOURNAL ARTICLE
============================================================

============================================================
78.) Erythema annulare centrifugum caused by hydrochlorothiazide-induced interstitial nephritis.
============================================================
SO - Int J Dermatol 1988 Mar;27(2):129-30
AU - Goette DK; Beatrice E
PT - JOURNAL ARTICLE
============================================================

============================================================
79.) [Erythema annulare centrifugum disclosing hyperthyroidism]
============================================================
SO - Ann Dermatol Venereol 1988;115(6-7):721-3
AU - Launay P; Blanc D; Paris B; Quencez E; Drobacheff C; Zultak M
PT - JOURNAL ARTICLE
============================================================

============================================================
80.) Eruption resembling erythema annulare centrifugum due to thiacetazone [letter]
============================================================
SO - Australas J Dermatol 1987 Apr;28(1):44
AU - Ramesh V
PT - LETTER
============================================================

============================================================
81.) [Erythema annulare centrifugum caused by aldactone]
============================================================
SO - Ann Dermatol Venereol 1987;114(3):375-6
AU - Carsuzaa F; Pierre C; Dubegny M
PT - JOURNAL ARTICLE
============================================================

============================================================
82.) [On the physiopathology of erythema annulare centrifugum]
============================================================
SO - Ann Dermatol Venereol 1987;114(5):709-15
AU - Litoux P
PT - JOURNAL ARTICLE; REVIEW (22 references)
============================================================

============================================================
83.) Erythema annulare centrifugum associated with liver disease.
============================================================
SO - Arch Dermatol 1986 Nov;122(11):1239-40
AU - Tsuji T; Kadoya A
PT - JOURNAL ARTICLE
============================================================

============================================================
84.) [Erythema annulare centrifugum and Hashimoto's thyroiditis]
============================================================
SO - Ann Dermatol Venereol 1986;113(11):1087-8
AU - Thess F; Rigon JL; Cuny JF; Schmutz JL; Weber M; Beurey J
PT - JOURNAL ARTICLE
============================================================

============================================================
85.) Erythema annulare centrifugum associated with piroxicam [letter]
============================================================
SO - J Am Acad Dermatol 1985 Nov;13(5 Pt 1):840-1
AU - Hogan DJ; Blocka KL
PT - LETTER
============================================================

============================================================
86.) Annular erythema with histologic features of leukocytoclastic vasculitis in ulcerative colitis.
============================================================
SO - Cutis 1985 Mar;35(3):250-2
AU - Aram H; Rubinstein N; Granot E
PT - JOURNAL ARTICLE

============================================================
87.) Erythema annulare centrifugum and malignant histiocytosis--report of a case.
============================================================
SO - Clin Exp Dermatol 1984 Nov;9(6):608-13
AU - Dodd HJ; Kirby JD; Chambers TJ; Stansfeld AG
PT - JOURNAL ARTICLE
============================================================

============================================================
88.) Pityrosporum infection in an infant with lesions resembling erythema annulare centrifugum.
============================================================
SO - Arch Dermatol 1984 Mar;120(3):380-2
AU - Kikuchi I; Ogata K; Inoue S
PT - JOURNAL ARTICLE
AB - Erythematous, scaling patches over the face, torso, and extremities developed in a 2-month-old female infant. The facial lesions enlarged and became confluent, while the torso and leg lesions enlarged and assumed an annular configuration. Spores of Pityrosporum ovale and Pityrosporum orbiculare were found in large numbers in potassium hydroxide preparations from these lesions, a finding confirmed by culture. Clotrimazole ointment was applied, and the lesions resolved within one week, leaving depigmentation. The findings in this case and those of erythema gyratum atrophicans transiens neonatale resembled each other except for the demonstration of Pityrosporum spores. We assume that the disorder in our patient may represent superficial gyrate erythema (erythema annulare centrifugum) induced by Pityrosporum spores.


============================================================
89.) Erythema annulare centrifugum: a review of 24 cases with special reference to its association with underlying disease.
============================================================
SO - Clin Exp Dermatol 1983 Jul;8(4):383-7
AU - Mahood JM
PT - JOURNAL ARTICLE
============================================================

============================================================
90.) [Pemphigoid with recurrence of the centrifugal-development bullous annular erythema type]
============================================================
SO - Ann Dermatol Venereol 1983;110(12):1021-2
AU - Jeanmougin M; Lemarchand-Venencie F; Ribrioux A; Bardy-Decrion I; Civatte J
PT - JOURNAL ARTICLE
============================================================

============================================================
91.) [Bullous pemphigoid with an erythema annulare centrifugum appearance and a bullous border]
============================================================
SO - Ann Dermatol Venereol 1983;110(12):1017-8
AU - Chouvet B; Barthelemy H; Forestier JY; Hermier C; Thivolet J
PT - JOURNAL ARTICLE
============================================================

============================================================
92.) [Erythema annulare centrifugum and antinuclear antibodies]
============================================================
SO - Ann Dermatol Venereol 1983;110(9):711-2
AU - Elnekave FL; Puissant A; Morel P; Noury-Duperrat G; Beltzer-Garelly E
PT - JOURNAL ARTICLE
============================================================

============================================================
93.) Erythema annulare centrifugum. A case due to tuberculosis.
============================================================
SO - Int J Dermatol 1982 Nov;21(9):538-9
AU - Burkhart CG
PT - JOURNAL ARTICLE
============================================================

============================================================
94.) Erythema annulare centrifugum and Graves' disease [letter]
============================================================
SO - Arch Dermatol 1982 Sep;118(9):623
AU - Braunstein BL
PT - LETTER
============================================================

============================================================
95.) Cimetidine-induced erythema annulare centrifugum: no cross-sensitivity with ranitidine.
============================================================
SO - Br Med J (Clin Res Ed) 1981 Sep 12;283(6293):698
AU - Merrett AC; Marks R; Dudley FJ
PT - JOURNAL ARTICLE
============================================================

============================================================
96.) [Nosologic problems posed by a case of desquamative erythema annulare centrifugum]].
============================================================
Bull Soc Fr Dermatol Syphiligr 1971;78(1):55

[Article in French]

Chasseuil M
============================================================

============================================================
97.) [Erythema annulare centrifugum Darier as a reaction form in diseases of the reticulo-histiocyte system].
============================================================
Dermatol Wochenschr 1967 May 27;153(21):604-12

[Article in German]

Kimmig J, Rohde B, Janner M
============================================================

============================================================
98.) [Erythema annulare centrifugum of Darier, squamous variety].
============================================================
Bull Soc Fr Dermatol Syphiligr 1966 Jan-Feb;73(1):111-3

[Article in French]

Labouche F, Henaff R
============================================================

============================================================
99.) [Erythema annulare centrifugum with loco-regional recurrences during the course of tuberculous coxitis. Focal reaction to tuberculin].
============================================================
Bull Soc Fr Dermatol Syphiligr 1965 May-Jun;72(3):259-62

[Article in French]

Coste F, Piguet B, Bontoux D
============================================================
100.) The Gyrate Erythemas
============================================================
seminars of dermatology 1984 Dec;3(4):327-336

Harry J. Hurley, MD, Jeffrey P.
============================================================
===========================================
101) ERYTHEMA ANNULARE CENTRIFUGUM. A CASE DUE TO HYPERSENSITIVITY TO BLUE CHEESE PENICILLIUM.
SHELLEY WB.
===========================================
Arch Dermatol. 1964 Jul;90:54-8.

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102.) Erythema annulare centrifugum in a patient with crohn disease.
=====================================================================
J Cutan Med Surg. 2012 Nov-Dec;16(6):442-4.
Samycia M1, Salopek TG.
Author information

1Division of Dermatology and Cutaneous Sciences, University of Alberta, Edmonton, AB T6G 2G3.

Abstract
BACKGROUND:

Erythema annulare centrifugum (EAC) represents a hypersensitivity reaction to a variety of conditions, many of which have been reported in the literature.
METHODS AND RESULTS:

We report on a 38-year-old woman with a 5-year history of recurrent polycylic, arcuate, scaly, erythematous patches with central clearing on her thighs and trunk. Clinical examination and biopsy were both consistent with a diagnosis of EAC. Two years after the initial presentation, she was diagnosed with mild Crohn disease.
CONCLUSIONS:

The prolonged nature of EAC in our patient and our inability to identify known associations of malignancies, including medications, connective tissue disorders, systemic disorders, and infections, led us to postulate that her EAC was related to her Crohn disease. A thorough review of the literature failed to detect any previous reports linking Crohn disease and EAC.
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103.) Erythema annulare centrifugum associated with herpes zoster.
======================================================
J UOEH. 2012 Sep 1;34(3):225-9.

Ohmori S1, Sugita K, Ikenouchi-Sugita A, Nakamura M.
Author information

1Department of Dermatology, School of Medicine, University of Occupational and Environmental Health, Japan.

Abstract

Erythema annulare centrifugum (EAC) presents as erythematous or urticarial papules, each with an annular shape, that exhibit peripheral extension. Internal malignancies are occasionally associated with EAC, and infectious diseases, including fungal, bacterial or viral infections, have also been regarded as possible causes of EAC. A 35-year-old man had a 1-week history of a painful vesicular eruption over the trunk corresponding to dermatomes Th8-10. Concomitantly, he developed several annular eruptions over the trunk. We diagnosed the former lesions as herpes zoster and the latter as EAC associated with herpes zoster. Although DNA was extracted from the EAC region, no varicella-zoster virus DNA was detected. We consider that this is Wolf's isotopic response, which is caused by an alteration of the local immunity due to viral infection. An etiologic relationship between EAC and herpes zoster is strongly suggested by the present case and by our review.

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104.) Paraneoplastic erythema annulare centrifugum eruption: PEACE.
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Am J Clin Dermatol. 2012 Aug 1;13(4):239-46. doi: 10.2165/11596580-000000000-00000.

Chodkiewicz HM1, Cohen PR.
Author information

1Medical School, The University of Texas Houston Medical School, Houston, TX, USA.

Abstract

Erythema annulare centrifugum is a reactive erythema of various possible etiologies including, although less often, an associated cancer. Cancer-related erythema annulare centrifugum is most commonly associated with lymphoproliferative malignancies, specifically lymphoma and leukemia. Malignancy-associated erythema annulare centrifugum is more frequently seen in women than men and the presence of skin lesions usually precedes the clinical diagnosis of the underlying malignancy. Neoplasm-derived erythema annulare centrifugum lesions often resolve following treatment of the cancer. Recurrence of erythema annulare centrifugum may occur along with the relapse of the underlying malignancy. Paraneoplastic erythema annulare centrifugum eruption (PEACE) is speculated to be a result of a cytokine or other tumor-associated factors.
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105.) The expanding spectrum of cutaneous borreliosis.
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G Ital Dermatol Venereol. 2009 Apr;144(2):157-71.

Eisendle K1, Zelger B.
Author information

1Department of Dermatology and Venerology, Innsbruck Medical University, Innsbruck, Austria. Klaus.eisendle@uki.at

Abstract

The known spectrum of skin manifestations in cutaneous Lyme disease is continuously expanding and can not be regarded as completed. Besides the classical manifestations of cutaneous borreliosis like erythema (chronicum) migrans, borrelial lymphocytoma and acrodermatitis chronica atrophicans evidence is growing that at least in part also other skin manifestations, especially morphea, lichen sclerosus and cases of cutaneous B-cell lymphoma are causally related to infections with Borrelia. Also granuloma annulare and interstitial granulomatous dermatitis might be partly caused by Borrelia burgdorferi or similar strains. There are also single reports of other skin manifestations to be associated with borrelial infections like cutaneous sarcoidosis, necrobiosis lipoidica and necrobiotic xanthogranuloma. In addition, as the modern chameleon of dermatology, cutaneous borreliosis, especially borrelial lymphocytoma, mimics other skin conditions, as has been shown for erythema annulare centrifugum or lymphocytic infiltration (Jessner Kanof) of the skin.
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106.) Linear IgA dermatosis presenting with erythema annulare centrifugum lesions: report of three cases in adults.
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J Eur Acad Dermatol Venereol. 2001 Mar;15(2):167-70.

Dippel E1, Orfanos CE, Zouboulis C.
Author information

1Department of Dermatology, University Medical Center Benjamin Franklin, The Free University of Berlin, Germany.

Abstract

Linear IgA dermatosis presented with erythema annulare centrifugum lesions in three elderly women. Search for underlying malignancy revealed low-grade B-cell lymphoma in one case. In addition to subepidermal blistering, histology showed a typical mixed infiltrate of granulocytes and eosinophils and, occasionally, papillar microabsesses in one case. In the two other subjects, characteristic subepidermal lining with granulocytes was observed. Immunofluorescence studies confirmed the diagnosis, while autoantibodies characteristic for dermatitis herpetiformis were absent. To our knowledge this is the second report of adult linear IgA dermatosis in association with erythema annulare centrifugum lesions. Our observations concord with several other reports of figurate erythema associated with autoimmune blistering disease and other immune disorders. Common antibody-related immunological mechanisms indicate that the two distinct clinical pictures are probably stages of the same pathogenic entity.
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107.) A new type of annular erythema with perieccrine inflammation: erythema papulatum centrifugum.
========================================================
Dermatology. 2013;226(4):298-301. doi: 10.1159/000348708. Epub 2013 Aug 14.

Ohmori R1, Kikuchi K, Yamasaki K, Aiba S.
Author information

1Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan.

Abstract

Erythema papulatum centrifugum (EPC) was first described in 1962 by Watanabe [Jpn J Dermatol 1962;72:573] as eczematous lesions extending centrifugally. To date, more than 150 cases have been reported, but only in the Japanese literature. A review of the Japanese literature including our 5 new cases reveals that EPC occurs in middle-aged persons, predominantly in males, as a single lesion on the trunk that is self-limiting but recurs frequently. Although EPC shares several characteristics with the superficial type of erythema annulare centrifugum or asymmetrical periflexural exanthema, EPC differs from erythema annulare centrifugum in clinical manifestation, showing annular rings composed of grouped, tiny papules, and in the histology of perieccrine inflammation, while it differs from asymmetrical periflexural exanthema by male preponderance, onset age, high relapse rate and unique annular configuration. We discuss EPC as compared with other cutaneous disorders showing annular erythema or similar histopathology and suggest that EPC is a distinct clinical entity.


  

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