Skin-nontumor / Clinical Dermatology - Erythema elevatum diutinum

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Skin-nontumor / Clinical Dermatology

Other dermatoses

Erythema elevatum diutinum

Reviewer: Nat Pernick, M.D., PathologyOutlines.com, Inc. (see Reviewers page)
Revised: 29 July 2011, last major update July 2011
Copyright: (c) 2002-2011, PathologyOutlines.com, Inc.

General
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● Bilaterally symmetric erythematous or violaceous plaques or nodules, often over outer surface of joints
● Systemically ill patients or associated with HIV
● May be related to granuloma faciale
● May be an immune-complex vasculitis induced by chronic antigen exposure

Case reports
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● 53 year old man with HIV (Dermatol Online J 2003;9:37)

Clinical images
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Numerous firm brown tumors on extensor surfaces of extremities

Gross images
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Nodules removed from hand

Micro description
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● Leukocytoclastic vasculitis, progressing to fibrosis and onion skinning around vessels
● Extracellular lipid deposits may be present in late lesions; no/rare eosinophils

Micro images
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Small vessel vasculitis

Whorled fibromatous pattern

Bland spindle cells, neutrophils and extravasated red blood cells

Differential diagnosis
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● Localized chronic fibrosing vasculitis: different clinical findings

Additional references
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● eMedicine

End of Skin-nontumor / Clinical Dermatology > Other dermatoses > Erythema elevatum diutinum

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