Erythema Annulare Centrifugum

Sinónimos
  • Superficial or deep gyrate erythema
  • Erythema perstans
  • Erythema gyratum perstans
 
Apresentação clínica
  • Annular erythema that migrantes centrifugally
  • Two major forms:
    • Superficial (trailing scale)
    • Deep (infiltrated border)
  • More common in adults
  • Superficial form favours the thighs and hips
  • Last for several days to a few moths
  • Often idiopathic, but associated with infections (tinea pedis), drugs or neoplasms
 
Mecanismo: Reaction pattern or hypersensitivity to one of many antigens
  • Most Common: infection (if you see EAC look at the feet)
    • Tinea pedis>>>>>> candida, poxvirus, parasites
  • Drugs: diuretics, antimalarials, gold, nsaids, finasteride, amitryptiline, nivolumab, sorafenib, rituximab, pegylated interferon alfa 2a plus rivabirin, ustekinumab
  • Crohn disease
  • Pregnancy
  • Autoimmune endocrinopathies
  • Hypereosinophilic syndromes
  • Neoplasms (++linfomas) (paraneoplastic)
 
Diagnóstico diferencial de lesões anulares - considerar fazer uma bióspsia
 
Tratamento
  • Treat underlying disorder
  • Topical corticosteroids or tar ointments
  • Systemic therapies are seldom necessary
    • Systemic corticosteroids
    • Antihistamines
    • Empiric antimicrobials (eg. macrolides, metronidazol) or antifungals
    • Heals with no residual scarring
    • Phototherapy (nb-UVB)
    • Apremilast
    • Subcutaneous etanercept
    • Subcutaneous interferon alpha