Erythema Annulare Centrifigum

Diagnosis: Erythema Annulare Centrifigum

Annular and arcuate plaques with trailing edge of scale characteristic of erythema annulare centrifigum.

Clinical Presentation

Annular and arcuate plaques with trailing edge of scale characteristic of erythema annulare centrifigum.

Clinical History

Submitted by Alaa Saad. Originally posted October 23, 2010.

Treatment

See case discussion.

Differential Diagnosis

• Tinea corporis • Granuloma annulare • Psoriasis (annular) • Erythema chronicum migrans (Lyme) • Subacute cutaneous lupus • Mycosis fungoides • Erythema gyratum repens

Key Learnings

• Annular, figurate erythema with a characteristic trailing scale inside the advancing border • "Trailing scale" sign: scale is on inner margin of advancing edge — pathognomonic • Superficial type: scaling, less induration. Deep type: firm, no scale • Often idiopathic, but associated with: infections (dermatophytes, Candida), drugs, and occasionally malignancy • Erythema gyratum repens (parallel wavy bands — "wood grain" pattern): more concerning for malignancy • Chronic, recurring course — lesions expand centrifugally at ~2-5mm/day

Tags: erythema, annulare, centrifigum, alaa saad