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The article discusses a case of Erythema annulare centrifugum (EAC) in a 72-year-old man with indolent lymphoma. The patient presented with annular erythematous plaques on his legs and back, along with weight loss. Despite declining bone marrow evaluation and chemotherapy, the patient's skin lesions improved with topical treatment and traditional medicine. The article explores the association between EAC and malignancies, highlighting the challenges in managing paraneoplastic skin features. [Extracted from the article]

Introduction: An undesirable consequence of modern medicine and pharmacology is the occurrence of drug reactions. Drug-induced cutaneous reactions account for approximately 70% of all clinical manifestations of adverse drug effects. This can be attributed to the fact that the skin, a signaling organ, is the largest body organ and exhibits significant metabolic/immunological activity. Case report: We present the case of a woman with drug-induced subacute cutaneous lupus erythematosus, primary diagnosed as erythema annulare centrifugum, who was hospitalized in the in the Department of Dermatology. Conclusions: Knowing that the prevalence of drug-induced subacute cutaneous lupus erythematosus appears to be considerably higher (70%) than previously estimated (20%), the diagnosis of drug-induced subacute cutaneous lupus erythematosus should also be considered when idiopathic subacute cutaneous lupus erythematosus is suspected, particularly if several therapeutics are utilized in patients older then 60 years. [ABSTRACT FROM AUTHOR]

Introduction: Erythema annulare centrifugum (EAC) is a rare reactive disease that typically presents as annular or polycyclic erythematous lesions. There are few studies about EAC in the literature; therefore, data on the pathogenesis of the disease are limited. Objectives: We aimed to examine the demographic, clinical, pathological characteristics and associated conditions of the patients with EAC. Methods: We analyzed records of the patients with EAC who admitted to our clinic in the last four years retrospectively. Results: A total of 63 patients, 39 women and 24 men, were included in our study. The mean age of the patients was 47.8±11.2 years. The mean disease duration was 15.54±12 months. The trunk and thigh were the most commonly involved sites (49%, 33%). Associated conditions were identified in 52.3% of the patients. Infections (N = 16), malignancies (N = 6), rheumatic diseases (n=4) and drugs (n=4) were the most common precipitating factors respectively. The most common infections were superficial fungal infections and Helicobacter pylori infection. Histopathologically, 10 patients had deep type and 53 patients had superficial type EAC. We determined that the disease duration from the onset of the disease was longer (12.3 versus 16.2 months) and the number of attacks (1.2 versus 2.8 attacks) was higher in the superficial type when compared to the deep type (P = 0.042, P = 0.038). Conclusions: In our study, infections, malignancies and rheumatic diseases were among the most common etiologic factors. We would also like to draw attention to Helicobacter pylori infection as a precipitating factor which may be a novel finding.

We report the case of a 42-year-old woman with rheumatoid arthritis undergoing treatment with subcutaneous tocilizumab for the past 6 months. Three days after the administration, an asymptomatic inflammatory annular plaque of 4 cm with discrete whitish scales at the inner border margin developed at the injection site in the left iliac fossa. A smaller plaque in the left groin appeared soon after. The mycological exam was negative. Histology showed a lymphoplasmacytic superficial and deep perivascular, and periadnexal, dermal infiltrate, without epidermal changes. Lesions spontaneously regressed in 4 months. The diagnosis was clinically and histologically consistent with erythema annulare centrifugum, following the exclusion of other differential diagnoses. Erythema annulare centrifugum represents a delayed-type hypersensitivity reaction generally considered idiopathic or otherwise related to numerous triggers, including drugs such as biologics. We describe the first reported case of tocilizumab-induced erythema annulare centrifugum. This case should alert dermatologists to this relatively rare and complex entity and should raise awareness to cutaneous biologic drug reactions.

Tumor-associated erythema annulare centrifugum is commonly observed in leukemia and lymphoma. In this case, we reported erythema annulare centrifugum associated with lung cancer that resolved following targeted drug therapy. A 71-year-old man with psoriasis visited our hospital with erythema annulare and pruritus. Initially, he was prescribed cyclosporine at a dose of 2.5 mg/kg suspecting a worsening of his psoriasis; however, this treatment was ineffective. Signs of paraneoplastic skin syndrome were observed, leading to a diagnosis of epidermal growth factor receptor mutation-positive lung adenocarcinoma (cT3N2M1c, stage IV, exon 19 del). After initiating osimertinib at a dose of 80 mg, the skin rash improved, and the tumor size was reduced. The final diagnosis was paraneoplastic erythema annulare centrifugum associated with lung cancer. This case highlights the potential resolution of erythema annulare centrifugum through lung cancer therapy, emphasizing the importance of considering lung cancer differential diagnosis when this skin condition is present., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Kagabu et al.)

We report the case of a 42-year-old woman with rheumatoid arthritis undergoing treatment with subcutaneous tocilizumab for the past 6 months. Three days after the administration, an asymptomatic inflammatory annular plaque of 4 cm with discrete whitish scales at the inner border margin developed at the injection site in the left iliac fossa. A smaller plaque in the left groin appeared soon after. The mycological exam was negative. Histology showed a lymphoplasmacytic superficial and deep perivascular, and periadnexal, dermal infiltrate, without epidermal changes. Lesions spontaneously regressed in 4 months. The diagnosis was clinically and histologically consistent with erythema annulare centrifugum, following the exclusion of other differential diagnoses. Erythema annulare centrifugum represents a delayed-type hypersensitivity reaction generally considered idiopathic or otherwise related to numerous triggers, including drugs such as biologics. We describe the first reported case of tocilizumab-induced erythema annulare centrifugum. This case should alert dermatologists to this relatively rare and complex entity and should raise awareness to cutaneous biologic drug reactions. [ABSTRACT FROM AUTHOR]

Sipuleucel-T is a cellular immunotherapy approved for the treatment of metastatic castration-resistant prostate cancer. We report a patient developing an immune related adverse effect from sipuleucel-T drug-induced erythema annulare centrifugum-like eruption. A brief review of the mechanism and implications of this eruption are also included.

Annually recurring erythema annulare centrifugum (AR-EAC) is a rare variant, characterized by typical annular plaques recurring in the same period of the year. We describe 5 new cases and present a review of the literature. Patients were 3 females and 2 males with an age range of 25–55 years. Multiple annular plaques were located at the thighs in 4 patients and the neck in one patient. In 1 patient, a single lesion was present. Plaques were recurring in summer in 3 cases; in 1 case, in spring; and another patient, in winter since 3–4 years. Lesions were self-healing in few days or weeks. Histologically, the epidermis presented mild acanthosis with patchy spongiosis, slight parakeratosis, and mild exocytosis. There was a perivascular lympho-histiocytic infiltrate of variable intensity in the superficial dermis, with occasional eosinophils. In 1 case, the inflammatory infiltrate reached the deep dermis. Mucin deposition was absent. Phenotyping studies in 1 case revealed a predominance of T cells, with a small B-cell component. Moreover, a moderate number of CD123+ plasmacytoid dendritic cells and CD1a+ dendritic cells were noted. Fourteen cases of AR-EAC have been published previously. Collectively, patients’ age ranged from 16 to 83 years, with a mean age of 47 years and a disease duration of 1–30 years. Lesions affected more frequently extremities and recurred most commonly in summer. Patients were all in good general health. Topical corticosteroids were the mainstay of treatment. AR-EAC is a benign disorder, the nature of which remains enigmatic.

Chronic myeloid leukemia (CML), BCR-ABL1-positive, is classified as a myeloproliferative neoplasm predominantly composed of proliferating granulocytes and determined to have the Philadelphia chromosome/translocation t (9;22)(q34;q11.2). Skin is said to be the mirror to systemic diseases, with skin manifestations ranging from nonspecific cutaneous lesions to specific lesions. The cutaneous manifestations of CML are generally reddish-brown to violaceous papules and nodules, indurated or hemorrhagic plaques, perifollicular acneiform papules, bullae, and palpable purpura. Other unusual manifestations could be erythema nodosum, pyoderma gangrenosum, erythema annulare centrifugum, and so on. Here we present a case of a 50-year-old woman with a history of recurrent pruritic skin lesions and erythema annulare centrifugum as the presenting complaint of CML.

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Erythema annulare centrifugum (EAC) is a rare erythema characterized by erythematous and urticarial papules or annular plaques that enlarges centrifugally. The lesions usually involve the thighs and the legs. Several disorders are occasionally associated with EAC, infections, including mycoses, bacteria, or viruses and drugs have also been regarded as possible causes of this eruption. We present a 42-year-old dark-skinned woman affected by recurrent EAC that appeared secondary to influenza type A (H1N1). Histopathology showed a superficial form of EAC. In our case, a previous cytomegalovirus and Epstein-Barr virus (EBV) infection were identified and no underlying other diseases were found. Clarithromycin with calcipotriol betamethasone treatment was temporarily efficacious. In the last 3 years, the lesions started to appear every 2 weeks and tended to regress with local treatment after a variable period. We believe that the latent cytomegalovirus and the reactivity induced by EBV combined with influenza can determine, in our case, a cell mediate cutaneous immune response, which leads to the peculiar inflammatory disease known as EAC.

Erythema annulare centrifugum (EAC) is an infrequent cutaneous disease characterized by figurate erythematous eruptions that enlarge centrifugally at a rate of 1-3 mm/day with central clearing resulting in an annular or polycyclic appearance. The characteristic skin eruptions of EAC are associated with various underlying systemic disorders, including infections, autoimmune and endocrine diseases, malignancies, and the use of certain drugs like diuretics, non-steroidal antiinflammatory agents, antimalarials, gold, amitriptyline, finasteride, penicillins, and salicylates, though the causal association has not been established. Lesions usually involve the thighs, legs, and buttocks and are characterized histopathologically by dermal perivascular lymphohistiocytic infiltrate. EAC is a benign self-limited disease. A 64-year-old man with pulmonary nocardiosis, on treatment with co-trimoxazole, presented with peripherally spreading raised red-coloured eruptions over thighs, buttocks, and arms. He developed similar lesions in the past, which resolved spontaneously. Cutaneous examination revealed multiple discrete annular erythematous plaques over flexural areas, thighs and buttocks. Skin biopsy showed coat-sleeve peri-appendageal inflammatory infiltrate in the dermis. Pulmonary nocardiosis was confirmed by positive cultures from broncho-alveolar lavage and PCR. A diagnosis of erythema annulare centrifugum, deep type, possibly associated with nocardiosis and/or co-trimoxazole, was made. The lesions subsided after stopping co-trimoxazole. [ABSTRACT FROM AUTHOR]

Mycosis fungoides, the most common cutaneous T-cell lymphoma, is known to exhibit varied clinical presentations and mimic many other dermatoses. This morphological heterogeneity can often lead to initial misdiagnoses resulting in significant delays from symptom onset to diagnosis. We report a case of mycosis fungoides imitating clinical and histopathological features of erythema annulare centrifugum.

Background: Erythema annulare centrifugum (EAC) is a rare cutaneous disease characterized by erythematous and violaceous annular plaques that usually involved the thighs and the legs with unknown etiology. EAC has a clinical similar to tinea corporis but different in terms of therapy. Case: A 52-year-old woman was complain redness patches on her both legs and abdomen since 2 month. Redness patches appeared suddenly. Firstly, small patch like insect bite appeared in her abdomen, but rapidly spread into her extremities especially at lower legs accompanied with itchy. She never complains about pain and burning sensation on his rash. No complain about ear, nose and throat disturbances, She has complain about toothache since 3 month ago. Physical examination showed on extremities inferior dextra and sinistra, there were erythematous macules sharply marginated that is varying in size. Regio abdomen and extremitas superior there were hyperpigmentasi macule sharply marginated that is varying in size. A potassium hydroxide microscopic, examination showed a negative result for a fungal infection. A skin biopsy was performed and the histologic examination revealed epidermis with spongiosis and in dermis with infiltration hystiosit, eosinofil and lymphosit on capiler blood vessel. The clinical and histopathological features, with a supportive history of recurrent lesions, led to the diagnosis of EAC. We give patient with dexamethasone and cetirizine, the lesions regressed spontaneously 3 months after onset. Discussion: The main differential diagnosis in our patient include tinea corporis. Histopathology of the skin lesions was classical for EAC. EAC resolves either spontaneously or once the underlying disease has been successfully treated. Systemic glucocorticoids usually suppress EAC, but recurrence is common when these drugs are stopped.

Abstract Herpetiformis dermatitis is the best characterized extraintestinal manifestation of celiac disease (CD). However, other chronic heterogeneous skin lesions have been associated with CD and should be considered in the differential diagnosis.

Herpetiformis dermatitis is the best characterized extraintestinal manifestation of celiac disease (CD). However, other chronic heterogeneous skin lesions have been associated with CD and should be considered in the differential diagnosis. [ABSTRACT FROM AUTHOR]

Erythema annulare centrifugum (EAC) is a reactive figurate erythematous disease characterised by gyrate and annular plaques with erythema. The disease is generally known as involving the extremities and trunk, but sparing the face. We present a young male patient with recurring annular erythematous scaly lesions on his face, frequently in a year since four years, with no systemic involvement. Histologically, in addition to slight parakeratosis and spongiosis in the epidermis, there was superficial lymphocytic and histiocytic perivascular infiltration with the classic coat sleeve appearance of EAC in the dermis. Although uncommon, we suggest EAC should be considered in the differential diagnosis of relevant lesions on face. [ABSTRACT FROM AUTHOR]

Annually recurring erythema annulare centrifugum (AR-EAC) is a rare variant, characterized by typical annular plaques recurring in the same period of the year. We describe 5 new cases and present a review of the literature. Patients were 3 females and 2 males with an age range of 25–55 years. Multiple annular plaques were located at the thighs in 4 patients and the neck in one patient. In 1 patient, a single lesion was present. Plaques were recurring in summer in 3 cases; in 1 case, in spring; and another patient, in winter since 3–4 years. Lesions were self-healing in few days or weeks. Histologically, the epidermis presented mild acanthosis with patchy spongiosis, slight parakeratosis, and mild exocytosis. There was a perivascular lympho-histiocytic infiltrate of variable intensity in the superficial dermis, with occasional eosinophils. In 1 case, the inflammatory infiltrate reached the deep dermis. Mucin deposition was absent. Phenotyping studies in 1 case revealed a predominance of T cells, with a small B-cell component. Moreover, a moderate number of CD123+ plasmacytoid dendritic cells and CD1a+ dendritic cells were noted. Fourteen cases of AR-EAC have been published previously. Collectively, patients' age ranged from 16 to 83 years, with a mean age of 47 years and a disease duration of 1–30 years. Lesions affected more frequently extremities and recurred most commonly in summer. Patients were all in good general health. Topical corticosteroids were the mainstay of treatment. AR-EAC is a benign disorder, the nature of which remains enigmatic. [ABSTRACT FROM AUTHOR]

Chronic myeloid leukemia (CML), BCR-ABL1-positive, is classified as a myeloproliferative neoplasm predominantly composed of proliferating granulocytes and determined to have the Philadelphia chromosome/translocation t (9;22)(q34;q11.2). Skin is said to be the mirror to systemic diseases, with skin manifestations ranging from nonspecific cutaneous lesions to specific lesions. The cutaneous manifestations of CML are generally reddish-brown to violaceous papules and nodules, indurated or hemorrhagic plaques, perifollicular acneiform papules, bullae, and palpable purpura. Other unusual manifestations could be erythema nodosum, pyoderma gangrenosum, erythema annulare centrifugum, and so on. Here we present a case of a 50-year-old woman with a history of recurrent pruritic skin lesions and erythema annulare centrifugum as the presenting complaint of CML. [ABSTRACT FROM AUTHOR]

Erythema annulare centrifugum (EAC) is a rare erythema characterized by erythematous and urticarial papules or annular plaques that enlarges centrifugally. The lesions usually involve the thighs and the legs. Several disorders are occasionally associated with EAC, infections, including mycoses, bacteria, or viruses and drugs have also been regarded as possible causes of this eruption. We present a 42-year-old dark-skinned woman affected by recurrent EAC that appeared secondary to influenza type A (H1N1). Histopathology showed a superficial form of EAC. In our case, a previous cytomegalovirus and Epstein-Barr virus (EBV) infection were identified and no underlying other diseases were found. Clarithromycin with calcipotriol betamethasone treatment was temporarily efficacious. In the last 3 years, the lesions started to appear every 2 weeks and tended to regress with local treatment after a variable period. We believe that the latent cytomegalovirus and the reactivity induced by EBV combined with influenza can determine, in our case, a cell mediate cutaneous immune response, which leads to the peculiar inflammatory disease known as EAC. [ABSTRACT FROM AUTHOR]

Mycosis fungoides, the most common cutaneous T-cell lymphoma, is known to exhibit varied clinical presentations and mimic many other dermatoses. This morphological heterogeneity can often lead to initial misdiagnoses resulting in significant delays from symptom onset to diagnosis. We report a case of mycosis fungoides imitating clinical and histopathological features of erythema annulare centrifugum. [ABSTRACT FROM AUTHOR]

Erythema annulare centrifugum (EAC) is characterised by slowly enlarging annular erythematous lesions and is thought to represent a clinical reaction pattern to infections, medications, and rarely, underlying malignancy. Causative drugs include chloroquine, cimetidine, gold sodium thiomalate, amitriptyline, finasteride, etizolam etc. We present a case of 40-year-old woman who presented to us with a 10 days history of nonpruritic, peripherally growing annular erythematous eruption. She had a history of recent onset of joint pain, for which she was taking aceclofenac 90 mg once a day for 5 days prior to the onset of the rash. This was confirmed on biopsy as EAC. The rash promptly subsided after stopping the drug. We report this case as there was no previous report of aceclofenac induced EAC.

Erythema annulare centrifugum (EAC) is characterized by annular, erythematous plaques with trailing scale. The skin lesions may be indurated or soft and may be static or spread centrifugally. It is considered to be a reactive condition with a wide variety of inciting causes but unclear pathophysiology. We describe a 62-year-old man with EAC. Since no association of EAC with concomitant bacterial or viral infections, we started diagnostics in the direction of systemic disease or cancer. Investigations confirmed carcinoma of larynx. We want to emphasize that EAC can appear many years before the onset of carcinoma. This is the first description of the ECM and carcinoma of the larynx with a long list of co-existing cancers. [ABSTRACT FROM AUTHOR]