Evaluation of Clinicopathological Features and Associated Conditions in Erythema Annulare Centrifugum: A Retrospective Observational Analysis of 63 Patients
Keywords:
Erythema annulare centrifugum, clinicopathological features, associated conditionsAbstract
Introduction: Erythema annulare centrifugum (EAC) is a rare reactive disease that typically presents as annular or polycyclic erythematous lesions. There are few studies about EAC in the literature; therefore, data on the pathogenesis of the disease are limited.
Objectives: We aimed to examine the demographic, clinical, pathological characteristics and associated conditions of the patients with EAC.
Methods: We analyzed records of the patients with EAC who admitted to our clinic in the last four years retrospectively.
Results: A total of 63 patients, 39 women and 24 men, were included in our study. The mean age of the patients was 47.8±11.2 years. The mean disease duration was 15.54±12 months. The trunk and thigh were the most commonly involved sites (49%, 33%). Associated conditions were identified in 52.3% of the patients. Infections (N = 16), malignancies (N = 6), rheumatic diseases (n=4) and drugs (n=4) were the most common precipitating factors respectively. The most common infections were superficial fungal infections and Helicobacter pylori infection. Histopathologically, 10 patients had deep type and 53 patients had superficial type EAC. We determined that the disease duration from the onset of the disease was longer (12.3 versus 16.2 months) and the number of attacks (1.2 versus 2.8 attacks) was higher in the superficial type when compared to the deep type (P = 0.042, P = 0.038).
Conclusions: In our study, infections, malignancies and rheumatic diseases were among the most common etiologic factors. We would also like to draw attention to Helicobacter pylori infection as a precipitating factor which may be a novel finding.
References
McDaniel B, Cook C. Erythema Annulare Centrifugum. 2022 In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023. PMID: 29494101.
Mandel VD, Ferrari B, Manfredini M, Giusti F, Pellacani G. Annually recurring erythema annulare centrifugum: a case report. J Med Case Rep. 2015;22;9:236. DOI: 10.1186/s13256-015-0718-1. PMID: 26496986. PMCID: PMC4619197.
Darier J. De l’erytheme annulaire centrifuge. Ann Dermatol Syphilol. 1916; 6: 57-76.
Weyers W, Diaz-Cascajo C, Weyers I. Erythema annulare centrifugum: results of a clinicopathologic study of 73 patients. Am J Dermatopathol. 2003;25(6):451-462. DOI: 10.1097/00000372-200312000-00001. PMID: 14631185.
Kim DH, Lee JH, Lee JY, Park YM. Erythema Annulare Centrifugum: Analysis of Associated Diseases and Clinical Outcomes according to Histopathologic Classification. Ann Dermatol. 2016;28(2):257-259. DOI: 10.5021/ad.2016.28.2.257. PMID: 27081281. PMCID: PMC4828397.
Kim KJ, Chang SE, Choi JH, Sung KJ, Moon KC, Koh JK. Clinicopathologic analysis of 66 cases of erythema annulare centrifugum. J Dermatol. 2002;29(2):61-67. DOI: 10.1111/j.1346-8138.2002.tb00167.x. PMID: 11890297.
Sardana K, Chugh S, Mahajan K. An observational study of the efficacy of azithromycin in erythema annulare centrifugum. Clin Exp Dermatol. 2018;43(3):296-299. DOI: 10.1111/ced.13334. PMID: 29297941
Chodkiewicz HM, Cohen PR. Paraneoplastic erythema annulare centrifugum eruption: PEACE. Am J Clin Dermatol. 2012;13(4):239-246. DOI: 10.2165/11596580-000000000-00000. PMID: 22320680.
Topal IO, Topal Y, Sargan A, et al. Erythema annulare centrifugum as presenting sign of activation of breast cancer. An Bras Dermatol. 2015;90(6):925-927. DOI: 10.1590/abd1806-4841.20154785. PMID: 26734884. PMCID: PMC4689091.
Kruse LL, Kenner-Bell BM, Mancini AJ. Pediatric Erythema Annulare Centrifugum Treated with Oral Fluconazole: A Retrospective Series. Pediatr Dermatol. 2016;33(5):501-506. DOI: 10.1111/pde.12909. PMID: 27339688.
Chuang FC, Lin SH, Wu WM. Erythromycin as a Safe and Effective Treatment Option for Erythema Annulare Centrifugum. Indian J Dermatol. 2015;60(5):519. DOI: 10.4103/0019-5154.159633. PMID: 26538713. PMCID: PMC4601434.
Gniadecki R. Calcipotriol for erythema annulare centrifugum. Br J Dermatol. 2002;146(2):317-319. DOI: 10.1046/j.0007-0963.2001.04572.x. PMID: 11903248.
De Aloe G, Rubegni P, Risulo M, Sbano P, Poggiali S, Fimiani M. Erythema annulare centrifugum successfully treated with metronidazole. Clin Exp Dermatol. 2005;30(5):583-584. DOI: 10.1111/j.1365-2230.2005.01796.x. PMID: 16045701.
Guillet MH, Dorval JC, Larrégue M, Guillet G. Erythème annulaire centrifuge de darier à ddebut néonatal avec 15 ans de suivi. Efficacité de l'interféron et rôle de cytokines [Darier's erythema annulare centrifugum of neonatal onset with a 15 years' follow-up. Efficacy of interferon and role of cytokines]. Ann Dermatol Venereol. 1995;122(6-7):422-426. PMID: 8526425.
Lee MS, Klebanov N, Yanes D, Stavert R. Refractory erythema annulare centrifugum treated with apremilast. JAAD Case Rep. 2021;15:100-103. DOI: 10.1016/j.jdcr.2021.07.012. PMID: 34466643. PMCID: PMC8387728.
Jalil P, Masood S, Fatima S. Erythema Annulare Centrifugum: A Rare Skin Manifestation of Hashimoto Thyroiditis. Cureus. 2020;12(8):e9906. DOI: 10.7759/cureus.9906. PMID: 32968569. PMCID: PMC7505531.
Chiang CH, Lai FJ. Pregnancy-associated erythema annulare centrifugum. J Formos Med Assoc. 2015;114(7):670-671. DOI: 10.1016/j.jfma.2014.01.004. PMID: 24548620.
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