Erythema Annulare Centrifugum

Excerpt

Erythema annulare centrifugum is an annular, erythematous lesion that appears as urticarial-like papules, enlarges centrifugally, and clears centrally. A fine scale, called a trailing scale, is sometimes inside the advancing edge. Erythema annulare centrifugum is classified as a reactive erythema and has been associated with various underlying conditions, including malignancies. When erythema annulare centrifugum occurs as a paraneoplastic phenomenon, the lesion has been designated paraneoplastic erythema annulare centrifugum eruption. Women are more likely to experience paraneoplastic erythema annulare centrifugum eruption, which typically precedes the clinical diagnosis of malignancy and may recur with subsequent relapses.

In 1881, Colcott-Fox described erythema gyratum perstans as persistent, ring-shaped lesions with pruritus. The term erythema annulare centrifugum was introduced by Darier in 1916, whereas the name erythema perstans is still used by some authors to describe similar annular erythemas. All of these previous terms refer to clinical or pathologic variants of the entity now referred to as erythema annulare centrifugum. Some dermatologists preferred distinguishing the 2 histologically different forms (superficial and deep) as superficial and deep gyrate erythema. In contrast, others believed that the superficial and deep forms were unrelated and should not be referred to by the same name. Erythema annulare centrifugum is one of the three major figurative erythemas. These dermatoses exhibit advancing erythematous, annular lesions as a common presentation. However, each type possesses unique clinical and histopathological characteristics. When the other major figurate erythemas, such as erythema marginatum, erythema migrans, and erythema gyratum repens, are excluded, this is a diagnosis of exclusion.