Erythema annulare centrifugum
This covers a number of chronic annular (ring-shaped) and erythematous (red) skin eruptions. A large number of other descriptive terms have been used to classify these types of lesions, some of which include figurate erythema, annular erythema, erythema perstans, erythema gyratum perstans, erythema gyratum repens and erythema figuratum perstans.
Erythema gyratum repens
(due to gastric carcinoma)
What are the signs and symptoms?
Eruptions may occur at any time throughout life, from infancy to old age. The eruption usually begins as small raised pink-red spot that slowly enlarges and forms a ring shape while the central area flattens and clears. There may be an inner rim of scale. The rings enlarge at a rate of about 2-5 mm/day until they reach a diameter of about 6-8 cm. Sometimes the lesions do not form complete rings but grow into irregular shapes. One or several lesions may be present.
Lesions most often appear on the thighs and legs, but may occur on the face, trunk and arms. They are usually without symptoms but in some patients may cause mild itching.
What causes erythema annulare centrifugum?
Often no specific cause for the eruptions is found. However, it has been noted that erythema annulare centrifugum is sometimes linked to underlying diseases and conditions. These include:
- Bacterial, fungal and viral infections such as tuberculosis, sinusitis, candidiasis or tinea
- Drugs including chloroquine and hydroxychloroquine, oestrogen, penicillin and amitriptyline
- Cancer (especially the type known as erythema gyratum perstans, in which there are concentric and whirling rings)
- Food, most often blue cheese or tomatoes
- Recurrent or chronic appendicitis
- Cholestatic liver disease (blocked bile system)
- Graves disease (overactive thyroid gland)
In these situations, erythema annulare centrifugum resolves once the underlying cause is treated or the offending drug is stopped.
What is the treatment of erythema annulare centrifugum?
Erythema annulare centrifugum usually clears up by itself. Eruptions may be last from anywhere between a few weeks to many years (the average duration is 11 months). Most cases require no treatment, however topical corticosteroids may be helpful in reducing redness, swelling and itchiness.
Book: Textbook of Dermatology. Ed Rook A, Wilkinson DS, Ebling FJB, Champion RH, Burton JL. Fourth edition. Blackwell Scientific Publications.
On DermNet NZ:
- Erythema Annulare Centrifugum – from Medscape Reference
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