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Erythema elevatum dilutinum

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • rare localised cutaneous vasculitis in adults
  • idiopathic but may occasionaly occur in hepatitis, HIV or haematological malignancy (1)
    • other possible associations include (2) previous infection particularly by streptococcus or it can be a manifestation of occult neoplasia, including myeloma, myelodysplasia, or acute myelogenous leukaemia, and nonneoplastic disorders such as inflammatory bowel disease, relapsing polychondritis, and rheumatoid arthritis
    • there is no association with systemic vasculitis, and autoantibodies are not usually detected
  • red-purple plaques occur on the back of hands and joints; these plaques gradually harden and become yellow-brown
  • histology - leukocytoclasis with fibrosis and granuloma formation
    • even when the clinical course is chronic, the histological picture is acute (2) Microscopic features include angiocentric neutrophils with some leucocytoclasis, but fibrin is scanty
      • infiltrate is often mixed with some lipid-containing histiocytes
      • laminated angiocentric fibrosis again may be present.
  • treatment - dapsone treatment (1)

Reference:

  • (1) Dermatology in Practice (2003), 11(4), 14-18.
  • (2) Davies DJ. Small vessel vasculitis. Cardiovascular Pathology 2005; 14 (6): 335-346.

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