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Erythema Annulare Centrifugum at a Glance
  • Clinical pattern of annular expanding erythematous rings, which enlarge rapidly, fade, and then disappear, as new lesions appear.
  • Diagnosis of erythema annulare centrifugum is one of the exclusions.
  • Superficial and deep variants can be separated clinically and histologically. Deep form is usually lupus tumidus or erythema migrans.

The figurate erythemas include a variety of eruptions characterized by annular and polycyclic lesions. Classification of this group has always been controversial; the literature abounds with contradictions, uncertainties, and a bewildering array of synonyms. Darier in 1916 was the first to use the term erythema annulare centrifugum1 (EAC), although similar lesions had been described previously under other names. Table 43-1 lists the figurate erythemas and the differential diagnoses to consider.

Table 43-1 Migratory Erythemas

EAC is an uncommon disorder. No epidemiologic data are available. There are only three large series in the literature: (1) 66 cases identified clinically,2 (2) 73 first diagnosed histologically,3 and (3) 90 carrying either a clinical or histological diagnosis.4 EAC appears to have no predilection for either sex or for any age group.

Both the annularity and the peripheral spread of EAC have attracted speculation as to a possible mechanism. Most hypotheses have centered on interactions among inflammatory cells, their mediators, and ground substance as foreign antigens diffuse through the skin.5,6

While many possible triggers have been suggested, all are common ...

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