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Presentation
Case Findings: A 28-year-old soldier just returned from active duty in Iraq. He said the rash started several weeks ago. It is somewhat pruritic, but otherwise he feels well. He was given doxycycline, but it did not resolve.
1721% Lyme disease
1771% Leishmaniasis
1410% granuloma annulare
3664% erythema annulare centrifugum
Erythema annulare centrifugum (EAC) is a figurate erythema possibly related to hypersensitivity. The etiology of EAC has been postulated to be secondary to infection, inhalants, drugs, and malignancy, but in most cases, an etiologic agent is not identified. Most cases of EAC are idiopathic, but a number of agents have been reported to cause EAC-like lesions including piroxicam, penicillins, and others.
What To Look For:
- single or multiple erythematous papules (may also appear urticarial) that advance peripherally by millimeters per day
- erythematous papules eventually form large rings with central clearing and faint brownish pigmentation
- the ring may have a trailing scale behind the advancing edge
- lesions are slow moving and usually either arcuate or annular
To see more than 33 images of erythema annulare centrifugum with variations of disease, the differential diagnosis, management pearls and therapy options, .
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