New concepts on erythema annulare centrifugum: a clinical reaction pattern that does not represent a specific clinicopathological entity.
Br J Dermatol
; 160(1): 119-26, 2009 Jan.
Article
en En
| MEDLINE
| ID: mdl-18721189
ABSTRACT
BACKGROUND:
Erythema annulare centrifugum (EAC) is considered an inflammatory skin disease with unknown aetiology. In most textbooks it is assigned to the incoherent conglomeration of figurate or gyrate erythemas.OBJECTIVES:
To re-evaluate a large cohort of patients with EAC and to assess the evidence for infection with Borrelia.METHODS:
We retrospectively investigated 90 cases with the diagnosis of EAC. Haematoxylin and eosin sections were re-examined and diagnoses were specified; these were then confirmed by clinicopathological correlation. Infection with Borrelia was assessed by focus-floating microscopy and by a Borrelia-specific polymerase chain reaction (PCR).RESULTS:
Besides a miscellaneous group of annular disorders at times confused with EAC such as urticaria, leucocytoclastic vasculitis and psoriasis (20 of 90; 22%), EAC appeared to serve as a collective term for three main clinicopathological reaction patterns (i) (tumid) lupus erythematosus (29 of 90; 32%), (ii) spongiotic dermatitides (25 of 90; 28%) and (iii) pseudolymphoma (16 of 90; 18%). In 13 of 16 (81%) cases with a pseudolymphomatous reaction pattern spirochaetes stained positive but were negative in other reaction patterns of EAC as well as in negative controls. These findings were confirmed by a Borrelia-specific PCR which was positive in two of three (67%) of these pseudolymphomatous EAC cases but was negative in all other variants of EAC (none of five) as well as 20 controls.CONCLUSIONS:
We conclude that 'EAC' is a clinical reaction pattern that does not represent a specific clinicopathological entity and should lead to consideration of mainly lupus erythematosus, dermatitis and, in some cases, cutaneous Lyme disease.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Infecciones por Borrelia
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Lupus Eritematoso Cutáneo
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Dermatitis
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Eritema
Tipo de estudio:
Diagnostic_studies
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Observational_studies
Límite:
Adolescent
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Adult
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Aged
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Aged80
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Animals
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Child
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Br J Dermatol
Año:
2009
Tipo del documento:
Article
País de afiliación:
Alemania