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Skin-nontumor / Clinical Dermatology

Other dermatoses

Gyrate erythema


Reviewer: Mowafak Hamodat, MB.CH.B, MSc., FRCPC, Eastern Health, St. Johns, Canada (see Reviewers page)
Revised: 30 July 2011, last major update July 2011
Copyright: (c) 2002-2011, PathologyOutlines.com, Inc.

Definition
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● Various erytematous eruptions with a curvilinear ("gyrate") appearance:
Erythema annulare centrifugum: most common gyrate erythema, but etiology unknown; may grow over weeks, resolves in 1-2 months
Erythema marginatum rheumaticum: due to rheumatic fever, now extremely rare
Erythema gyratum repens: uncommon, paraneoplastic process associated with internal malignancy (eMedicine)
Erythema chronicum migrans: occurs after a tick bite, may be associated with Lyme disease (Wikipedia)

Terminology
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● Also called figurate erythema

Case reports
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● 64 year old woman with pruritic, erythematous plaques on abdomen and back that appeared and disappeared (PathologyOutlines Case of Week #71, Dermatology Case of Month #4)

Clinical features
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● Multiple waves of curvilinear erythema and scale
● Rash may migrate and be pruritic

Clinical images
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Erythema annulare centrifugum

Pregnant woman

Erythema gyratum repens
   
Various images

Erythema marginatum rheumaticum
   
Various images

Erythema chronicum migrans
       
Various images

Micro description
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● Non-specific changes
● Dense perivascular lymphocytic infiltrate of superficial dermis and possibly deep reticular dermis
● Lymphocytes are well demarcated and adjacent to vessels ("coat sleeve" or "pipe stem" appearance in erythem annulare centrifugum)
● Variable epidermal spongiosis, mild ancanthosis and parakeratosis; may have focal vacuolar changes

Micro images
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Erythema annulare centrifugum
   
Pregnant woman

Erythema gyratum repens
           
Various images

Erythema chronicum migrans
   
Various images

Positive stains
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● Erythema gyratum repens: occasional presence of C3, C4 and IgG at the basement membrane zone with direct immunofluorescence

End of Skin-nontumor / Clinical Dermatology > Other dermatoses > Gyrate erythema


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