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A 28-year-old female patient had been experiencing recurrent annular erythema on her trunk and lower extremities for three years. Dermatological examination revealed multiple edematous and erythematous plaques distributed across the abdomen, waist, buttocks, and lower extremities. These plaques exhibited partial central regression, leaving behind pigmentation, and raised borders, presenting in an annular or semi-annular pattern. Associated pigmentation was also observed on the trunk and lower extremities. Histopathological examination of the lesions demonstrated hyperkeratosis and mild hyperplasia in the epidermis. Additionally, there was capillary dilatation in the superficial and middle layers of the dermis. A perivascular infiltrate consisting of lymphocytes and a significant number of eosinophils was observed. Notably, some of the eosinophils exhibited a degranulation phenomenon. Furthermore, collagen hyperplasia and sclerosis were evident in the middle and lower layers of the dermis. Based on these findings, a diagnosis of eosinophilic annular erythema was made. After oral administration of traditional Chinese medicine soup for nearly half a year, which aims to clear heat and dampness, promote blood circulation, and unblock meridians, the skin lesions had basically subsided. The patient was currently under follow-up observation. [ABSTRACT FROM AUTHOR]

Erythema papulatum centrifugum (EPC), also known as erythema papulosa semicircularis recidivans, is a rare dermatological condition characterized by single or multiple annular or semi-annular centrifugally growing lesions surrounded by tiny erythematous papules typically observed on the trunk. EPC is prevalent, particularly in Japan and China, although only a few cases have been reported outside Asia. Herein, we present the case of a 47-year-old female from Thailand who experienced a pruritic annular erythematous rash on her right arm for two months. The diagnosis of EPC was established based on clinical manifestations and confirmed by histopathological examination. The lesions resolved after one month of treatment with 0.1% betamethasone valerate cream and avoiding warm weather. This case report contributes to the understanding of EPC, which may be underrecognized in clinical practice due to its self-limiting nature and frequent misdiagnosis. Furthermore, this article provides a comprehensive review of 17 previously reported cases of EPC, focusing on their detailed descriptions. [ABSTRACT FROM AUTHOR]

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The letter published in the Journal of Cutaneous Immunology & Allergy describes a case of immunoglobulin A (IgA) vasculitis in a 41-year-old man presenting with annular erythema on the abdomen. The patient had skin lesions, joint pain, and abdominal discomfort, with laboratory tests showing elevated inflammatory markers. Histopathological findings confirmed leukocytoclastic vasculitis with IgA deposition in the dermal vessels. The annular erythema resolved spontaneously without specific treatment, highlighting the importance of considering IgA vasculitis in patients with similar symptoms. [Extracted from the article]

Background: In humans, figurate erythema (FE) represents a heterogenous group of dermatoses with circular or serpiginous erythematous skin lesions; FE has not been reported in cats. Objectives: To report clinical and histological characteristics and outcomes of FE in sphynx cats from Baltic sea‐bordering countries. Animals: Eleven client‐owned sphynx cats with FE. Materials and Methods: We recruited cases meeting the following criteria: (i) a sphynx breed, (ii) FE with or without scaling, (iii) a chronic, waxing‐and‐waning course lasting longer than a month and (iv) an absence of other skin diseases. Results: Of 11 cats, there were seven Donskoys, one Peterbald, one Ukrainian Levkoy and two presumed Canadian sphynxes; all except one were males, and the age of onset was <12 months in eight cats. Skin lesions lasted between 1.2 and 56 months, and they consisted of erythematous plaques with a linear‐to‐serpiginous, annular, gyrate or iris configuration predominating on the trunk and extremities. Scaling was often seen trailing the edge of the centrifugally expanding erythema. All cats were otherwise asymptomatic or mildly pruritic. Dermatophytosis was ruled out by special stains and/or fungal cultures in eight cats. Microscopic lesions revealed focal, mild‐to‐moderate epidermal hyperplasia and hyperkeratosis, minimal‐to‐mild dysplasia and subepidermal collagen smudging. Special stains were negative for dermatophytes. The clinical remission of FE was not achieved with diet changes or medical interventions; yet, a spontaneous, transient, partial or complete improvement occurred in most cats. Conclusion and Clinical Relevance: This is the first report of FE in sphynx cats from Eastern Europe. [ABSTRACT FROM AUTHOR]

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Background: Annular erythema is a rare manifestation of leukocytoclastic vasculitis. It may be associated with various drugs, infections, malignancies, or systemic diseases. Case description: A 36-year-old woman with no personal medical history presented with annular erythema with target lesions and petechial purpura. The patient had fever and joint arthralgia. A skin biopsy showed leukocytoclastic vasculitis with IgA deposits on direct immunofluorescence. The diagnosis of immunoglobulin A vasculitis with annular leukocytoclastic vasculitis was made. The patient showed global improvement with topical steroids without relapse. Conclusion: An annular variant of leukocytoclastic vasculitis is a rare manifestation of immunoglobulin A vasculitis.

Key Clinical Message We report a case of leukemia cutis showing annular erythema during the course of Philadelphia chromosome‐positive acute B‐lymphoblastic leukemia. The annular appearance may be developed by immunomodulatory effects of blinatumomab.

Key Clinical Message: We report a case of leukemia cutis showing annular erythema during the course of Philadelphia chromosome‐positive acute B‐lymphoblastic leukemia. The annular appearance may be developed by immunomodulatory effects of blinatumomab. [ABSTRACT FROM AUTHOR]

Annular erythema of infancy is a rare, benign disease characterized by enlarging annular patches and plaques that resolve spontaneously. Histopathology typically demonstrates a perivascular mixed lymphohistiocytic infiltrate with increased eosinophils. We present two cases of annular erythema of infancy, at ages 2–4 weeks, and review the literature on annular erythema of infancy. It is important to differentiate this distinct, benign disease from serious autoimmune or infectious processes, such as neonatal lupus erythematosus and syphilis, which may present with similar annular lesions in infancy. [ABSTRACT FROM AUTHOR]

Jingya Zhang, Fei Qi, Xuan Zhang, Jie Dong, Chunguang Tong, Xiuying Zhang, Fang Liu Department of Dermatology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, People’s Republic of ChinaCorrespondence: Fang Liu, Department of Dermatology, Beijing Chaoyang Hospital, Capital Medical University, 8 Gongti South Road, Chaoyang District, Beijing, 100020, People’s Republic of China, Tel +86-10-85231688, Fax +86-10-85231217, Email roseliufang@qq.comAbstract: Sjögren’s syndrome (SJS) is a systemic disease in which the accumulated skin can include xeroderma, eyelid dermatitis, and annular erythema (AE). To the best of our knowledge, there are few reports on cases of SJS with concomitant lichen sclerosus (LS). Herein, we report the case of a 69-year-old woman with these two diseases. The patient’s skin showed atrophic leukoplakia and AE. Based on the comprehensive evaluation of general condition, the patient was diagnosed and actively received treatment. After systematic treatment, her symptoms were controlled. However, the patient’s condition requires long-term management.Keywords: annular erythema, skin atrophy, depigmentation, skin lesions

Annular erythema of infancy (AEI) is characterized by self‐limited eruptions of erythematous, annular to polycyclic patches and plaques, the etiology of which is thought to involve a hypersensitivity reaction to an unknown antigen. We present a case of AEI mistaken for systemic mastocytosis due to elevated serum tryptase. We were unable to find prior reports of an association between AEI and elevated tryptase in the literature. [ABSTRACT FROM AUTHOR]

Objective: Rare disease Background: Pityriasis rubra pilaris (PRP) is a rare chronic inflammatory skin condition characterized by follicular, papulosquamous, reddish-orange scaling, palmoplantar keratoderma, and erythema with islands of sparing. Its heterogeneous clinical presentation makes the diagnosis of PRP quite challenging, especially at the initial presentation, as it can mimic common skin conditions. Case Report: We present a case with an early presentation of PRP in a 61-year-old Malay woman with underlying uncontrolled diabetes, and discuss evolving clinical course of her disease. She presented to a primary care clinic with a 3-week history of itchy, ring-like skin lesions that started on her neck and chest but subsequently spread widely on her chest, back, and upper extremities. She was first treated as having extensive tinea corporis but responded poorly to multiple courses of antifungal treatment. An initial skin biopsy that was taken at the dermatology clinic revealed features suggestive of erythema annulare centrifugum. However, despite topical steroid treatment, her skin condition evolved further and she developed generalized erythroderma along with follicular hyperkeratosis and palmoplantar keratoderma. A repeat biopsy finally confirmed the diagnosis of PRP. Conclusions: Making the diagnosis of PRP is challenging for clinicians. However, clinicians should approach any common skin problem that does not respond to treatment appropriately, with consideration of other uncommon skin disorders. A repeat skin biopsy may be considered if there are any doubts about the diagnosis. A clinical and histopathological correlation is important to aid in the diagnosis of PRP. [ABSTRACT FROM AUTHOR]

In neurofibromatosis type 1 (NF-1), a Ras-pathway mutation disorder both celiac disease and juvenile myelomonocytic leukemia (JMML) have been found in association. A 3-year-old male child presented to us with annular erythema and cafe-au-lait macules (>6 in number). On investigation, he was found to have JMML and celiac disease. A child with early manifestation of NF1 in association with JMML and celiac disease is an even rarer presentation.

Introduction: Many conditions included under figurate erythemas have similar clinical appearance which makes diagnosis difficult. Among these, eosinophilic annular erythema (EAE) is a rare, uncommon, underreported entity in the pediatric population. Case Report: Herein, we report an 11-year-old boy who presented with asymptomatic recurrent, erythematous-edematous annular plaques with central hyperpigmentation. Discussion: Review of the literature shows scarce reporting of such cases globally and none from India. Clinicopathological findings of our case, suggest that eosinophilic annular erythema is a distinct entity rather than a type of Wells' syndrome.

BACKGROUND: The figurative erythemas are a group of inflammatory diseases, of unknown etiology, characterized by being annular, circinate, arcuate, in target or polycyclic, related to hypersensitivity. On the other hand, the cutaneous manifestations associated with the coronavirus disease 2019 (COVID-19) are becoming increasingly documented, its pathophysiological mechanisms are largely unknown, and the role of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) in its pathogenesis is still under debate. The evidence is cumulative that the skin manifestations of COVID-19 are extremely polymorphic. CLINICAL CASE: A 59-year-old male patient was admitted to the hospitalization area in an isolated guard for patients with COVID-19 suspected, the diagnosis was subsequently confirmed with a positive result of real time polymerase chain reaction for SARS-CoV-2, presented confluent annular circinate lesions, the histological study was compatible for the diagnosis of erythema annulare centrifugum. CONCLUSIONS: The skin manifestations of the SARS-CoV-2 are extremely polymorphic, little is known about its pathophysiology, and the fact that some of the same are caused by the viral infection or as a side effect of medications is still controversial. [ABSTRACT FROM AUTHOR]

Neutrophilic figurate erythema (NFE) is a rarely reported figurate erythema that clinically presents similarly to erythema annulare centrifugum (EAC) with neutrophil-predominant perivascular and interstitial infiltrate in the dermis on histopathology. We present the case of a 32-year-old active-duty military male who presented with a chronic treatment-resistant skin rash. The rash began on his thighs five years previously and was treated with topical and oral antifungals repeatedly without improvement. The patient was deployed overseas during the rash onset, but the rash persisted upon his return stateside. No triggers were identified. His persistent skin eruption consisted of erythematous polycyclic annular plaques with a "trailing edge" scale. Histologic examination revealed perivascular neutrophils and perivascular and interstitial eosinophils without signs of vasculitis or infection. With only 15 reported cases, it can be difficult to recognize leading to long delays in diagnosis and treatment. Despite having a clinical course similar to EAC, NFE may require anti-neutrophil therapy to resolve completely., Competing Interests: Human subjects: Consent 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, Meyer et al.)

Annular erythema, erythema papulosa semicircularis recidivans, erythema papulatum centrifugum, figurate erythema In fact, although Watanabe first described EPC in 1972, Song et al. reported this recurrent papulo-erythematous disease in 9 Chinese patients and named the same entity erythema papulosa semicircularis recidivans in 2012.[[1], [3], [5]] EPC predominantly affects men and is characterized by single annular or semi annular centrifugally expanding lesion on the trunk. Keywords: annular erythema; erythema papulatum centrifugum; erythema papulosa semicircularis recidivans; figurate erythema EN annular erythema erythema papulatum centrifugum erythema papulosa semicircularis recidivans figurate erythema 7212 7214 3 12/30/22 20221201 NES 221201 To the Editor, Erythema papulatum centrifugum (EPC), also known as erythema papulosa semicircularis recidivans, is a pruritic figurate erythema that is commonly seen in Japanese and Chinese patients.[[1], [3]] To date, only two cases of EPC have been described from countries outside Asia in English literature, namely Spain and North America.[[4]] Herein, we report two Turkish patients diagnosed with EPC. [Extracted from the article]

Annular erythema is one of the cutaneous manifestations of Sjögren's syndrome (SS). Topical corticosteroids and tacrolimus, and oral corticosteroids, have been used as treatments for this condition. However, the safety and efficacy of these treatments remains unsatisfactory, and further development of therapies are desired. In this study, we performed a retrospective analysis of 16 annular erythema associated with SS (AESS) patients treated with hydroxychloroquine (HCQ). Disease activity was assessed using a modified version of the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI), which we termed the modified CLASI (m‐CLASI). HCQ treatment improved AESS lesions in all 16 patients. The mean m‐CLASI score was reduced by 85.6% at the 12‐week follow‐up relative to baseline (p < 0.01). Notably, 60% (6/10 cases) of patients with AESS lesions limited to the facial area achieved complete remission within 4 weeks. In the analysis of six patients who had taken oral prednisolone before starting HCQ, all were able to reduce the dose within 52 weeks without relapse. Particularly, 75% (3/4 cases) of patients with prednisolone dose of more than 5 mg/day could reduce their dose to less than 5 mg/day in combination with HCQ. For the safety concerns, two patients experienced grade 1 diarrhea during the 52‐week observation period. However, neither serious adverse events nor adverse events requiring discontinuation of treatment occurred. The results of the present study suggest that HCQ may not only be highly effective as a single agent, but may also be useful as a steroid‐sparing agent in refractory case requiring long‐term steroid administration, making it a good treatment option for AESS. [ABSTRACT FROM AUTHOR]

We present a 76-year-old Japanese male with tinea faciei, tinea corporis, and tinea unguium with dermatophytoma. We performed fungal culture and confirmed the causative fungus to be Trichophyton rubrum. We treated the patient using oral fosravuconazole l-lysine ethanolate (F-RVCZ). More than one year has passed since the end of treatment, but there has been no recurrence. This case suggests that F-RVCZ is effective for tinea other than tinea unguium. [ABSTRACT FROM AUTHOR]

Introduction: Many conditions included under figurate erythemas have similar clinical appearance which makes diagnosis difficult. Among these, eosinophilic annular erythema (EAE) is a rare, uncommon, underreported entity in the pediatric population. Case Report: Herein, we report an 11-year-old boy who presented with asymptomatic recurrent, erythematous-edematous annular plaques with central hyperpigmentation. Discussion: Review of the literature shows scarce reporting of such cases globally and none from India. Clinicopathological findings of our case, suggest that eosinophilic annular erythema is a distinct entity rather than a type of Wells' syndrome. [ABSTRACT FROM AUTHOR]

Background: Annular erythema is a rare manifestation of leukocytoclastic vasculitis. It may be associated with various drugs, infections, malignancies, or systemic diseases., Case Description: A 36-year-old woman with no personal medical history presented with annular erythema with target lesions and petechial purpura. The patient had fever and joint arthralgia. A skin biopsy showed leukocytoclastic vasculitis with IgA deposits on direct immunofluorescence. The diagnosis of immunoglobulin A vasculitis with annular leukocytoclastic vasculitis was made. The patient showed global improvement with topical steroids without relapse., Conclusion: An annular variant of leukocytoclastic vasculitis is a rare manifestation of immunoglobulin A vasculitis., Learning Points: Annular erythema may reveal an IgA vasculitis.Annular leukocytoclastic vasculitis is a rare manifestation of IgA vasculitis.This presentation is treated with topical steroids., Competing Interests: Conflicts of Interests: The Authors declare that there are no competing interests., (© EFIM 2024.)

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Erythema papulatum centrifugum (EPC), also known as erythema papulosa semicircularis recidivans (EPSR), is distinct from eczema and other well‐described figurate erythemas characterised by annular erythematous lesions. We report 7 cases of EPC and propose new diagnostic criteria including the following: (i) EPC is characterised by single or multiple recurrent expanding annular or semi annular erythema with central regression, surrounded by tiny red papules; (ii) the lesions regularly relapse and resolve; (iii) the histopathologic feature shows superficial perivascular inflammation with or without mild inflammation around sweat glands in the mid dermis and (iv) patients lack other associated cutaneous or internal abnormalities. [ABSTRACT FROM AUTHOR]

The etiology of purpura in Sjögren syndrome (SS) includes cryoglobulinemia, hypergammaglobulinemia, and leukocytoclastic vasculitis (LCV). The clinical symptoms of LCV associated with SS comprise palpable or nonpalpable purpura and urticarial vasculitis. Here, we report a case of LCV presenting as erythema gyratum repens (EGR)-like purpura in a 62-year-old woman with rheumatoid arthritis and SS. EGR-like skin lesions, characterized by annular lesions with expanding concentric pattern and coalescing to form a zebra-like pattern or grain of wood pattern, can appear in various autoimmune conditions; however, EGR-like eruption in SS is extremely rare. On the basis of the expansion pattern, we considered that the EGR-like purpura in this case was elicited by urticarial vasculitis accompanied by SS.

The term Annular Erythema encompases a great number of entity which commonly present as annular lesions. Differention of one from another is sometimes difficult. Consideration of different aspects such as age, sex, onset, duration etc of these so called less discussed entities as well as clinic-pathological correlation is required to solve the puzzle. We brought about a concise yet lucid review of annular erythema compraising salient features of each entity. We also went through extensive literature search to highlight latest updates and scientific information of the same.

Sjögren syndrome (SS) is an autoimmune connective tissue disorder (CTD) that principally affects the lacrimal and salivary glands. Although SS is 1 of the 3 most common autoimmune CTDs alongside systemic lupus erythematosus and progressive systemic sclerosis, it is the least researched CTD overall. SS poses a particular diagnostic challenge because it shares multiple clinical and immunologic features with other CTDs. However, there are some characteristic cutaneous clinical features that can precede the well-known sicca symptoms by years. By familiarizing themselves with these clinical features and having a high suspicion for SS, dermatologists can play an important role in the early diagnosis and treatment of this disease. [ABSTRACT FROM AUTHOR]

Abstract: Background/Objectives: Lymphocytic hidradenitis is a non‐specific histopathological feature observed in many dermatoses such as lupus erythematosus, morphea or scleroderma. When it occurs it is usually accompanied by the other distinctive histological features of those conditions. Isolated lymphocytic hidradenitis is uncommon and its clinical features and associated underlying medical conditions are still undetermined. Methods: We performed a retrospective review of patients who clinically presented with annular erythema between 2000 and 2016. Altogether, 30 patients with a histopathological presentation of isolated lymphocytic hidradenitis were identified. Their following characteristics were recorded: clinical features, number and localisation of lesions, serology and other associated medical conditions. Results: Isolated lymphocytic hidradenitis was found most frequently in middle‐aged women. Most patients (n = 28, 93%) presented with many annular erythematous patches and plaques with mild pruritus; 22 (73%) had the SS‐A antibody and 17 (57%) met the diagnostic criteria of Sjögren syndrome. Among these patients, 11 had primary and six had secondary Sjögren syndrome associated with systemic lupus erythematosus. Altogether 15 (50%) patients tested positive for a high titre of the antinuclear autoantibody. Other underlying diseases identified during the follow‐up period include cryoglobulinaemia, angioimmunoblastic T‐cell lymphoma, autoimmune hepatitis, hepatitis C infection and toxic thyroid goitre. Conclusions: Lymphocytic hidradenitis is a microscopic finding associated with annular erythemas of Sjögren syndrome. Systemic survey for sicca symptoms and work up for autoimmune diseases, including antinuclear antibodies, SS‐A, SS‐B antibodies, cryoglobulin, lymphoma, viral and autoimmune hepatitis should be performed to facilitate the correct diagnosis. [ABSTRACT FROM AUTHOR]

Eosinophilic annular erythema (EAE) is a rare entity of unknown etiology that is possibly related to a hypersensitivity reaction and presents as annular erythematous plaques with tissue eosinophilia. It is classified as a figurate erythema with a controversial relationship to Wells syndrome (WS) in the literature, where it is generally considered a separate entity or subset based on clinical and histopathologic differences. EAE typically presents with recurrent, erythematous, arcuate, and annular plaques on the trunk and proximal extremities. The course of the disease is often chronic, recurrent, and relapsing. Responses to treatment are variable but are typically best with systemic steroids and antimalarials. We report a patient refractory to other therapies who had a striking response to dapsone. [ABSTRACT FROM AUTHOR]

The etiology of purpura in Sjögren syndrome (SS) includes cryoglobulinemia, hypergammaglobulinemia, and leukocytoclastic vasculitis (LCV). The clinical symptoms of LCV associated with SS comprise palpable or nonpalpable purpura and urticarial vasculitis. Here, we report a case of LCV presenting as erythema gyratum repens (EGR)-like purpura in a 62-year-old woman with rheumatoid arthritis and SS. EGR-like skin lesions, characterized by annular lesions with expanding concentric pattern and coalescing to form a zebra-like pattern or grain of wood pattern, can appear in various autoimmune conditions; however, EGR-like eruption in SS is extremely rare. On the basis of the expansion pattern, we considered that the EGRlike purpura in this case was elicited by urticarial vasculitis accompanied by SS. [ABSTRACT FROM AUTHOR]

Annular erythema with Sjögren's syndrome ( AESS) is occasionally found, especially in Asian patients, which is classified into three types. We present a case of Sjögren's syndrome showing various types of AESS with anti-signal recognition particle antibody-positive polymyositis. We successfully treated the eruption and myositis with a low dose of prednisolone. Every onset of annular erythema coincided with elevation of serum creatine kinase levels, which suggests the correlation between the activities of annular erythema and polymyositis. [ABSTRACT FROM AUTHOR]

The term Annular Erythema encompases a great number of entity which commonly present as annular lesions. Differention of one from another is sometimes difficult. Consideration of different aspects such as age, sex, onset, duration etc of these so called less discussed entities as well as clinic-pathological correlation is required to solve the puzzle. We brought about a concise yet lucid review of annular erythema compraising salient features of each entity. We also went through extensive literature search to highlight latest updates and scientific information of the same. [ABSTRACT FROM AUTHOR]

Although annular erythema is usually observed as one of the cutaneous manifestations of Sjögren's syndrome or subacute cutaneous lupus erythematosus, autoimmune blistering diseases also present with annular erythema. However, bullous lesions are not always found, and there is a rare type without bullous lesions. We present two cases of autoimmune blistering diseases showing annular erythema without bullous lesions. It is important to perform direct or indirect immunofluorescence examination when we encounter multiple annular erythema. [ABSTRACT FROM AUTHOR]

A 7-day-old premature female infant presented with rapidly progressive, erythematous, annular skin lesions from the 5 th day of life. She was diagnosed provisionally as a case of neonatal lupus erythematosus and was investigated accordingly. Histopathological examination of the skin biopsy specimen revealed presence of hyphae of dermatophytes in the stratum corneum, and the diagnosis was changed to tinea corporis. Differential diagnosis of the annular erythema of infancy has been discussed and the importance of scraping a scaly lesion for KOH preparation in the diagnostic work-up of such a patient has been highlighted.

Eosinophilic annular erythema (EAE) is a rare eosinophilic dermatosis characterized by annular, erythematous papules and plaques commonly found on the trunk and the extremities. There is continued debate on whether EAE is a distinct entity or a clinical polymorphism of Well's syndrome, but it is generally considered a separate entity based on clinical and histopathological differences. We present a case of EAE and discuss the histopathological findings. [ABSTRACT FROM AUTHOR]