Cold urticaria familial primary cold contact urticaria secondary cold contact urticaria reflex cold urticaria. Erythema gyratum repens is a clinically distinctive figurate or annular erythema that is usually associated with underlying malignancy. Erythema gyratum repens has also been noted in association with several nonmalignant conditions such as tuberculosis, linear iga dermatosis, psoriasis, pityriasis rubra pilaris, pemphigus vulgaris, bullous pemphigoid, ichthyosis, and hypereosinophilic syndrome. Erythema gyratum repens appears as concentric, scaly bands of erythema in a gyrate pattern, forming a wood grain appearance. Erythema gyratum repens as the initial manifestation of lung cancer. In this case report, we describe the condition of a 61yearold woman who presented with a generalized pruritic eruption that was shown to be egr. It occurs with any skin injury, infection, or inflammation.
Transformation from pityriasis rubra pilaris to erythema. Egr is associated with malignancy, most commonly bronchial, esophageal, and breast, in more than 80% of cases. Erythema gyratum repens associated with anal cancer nejm. Erythema gyratum repens an overview sciencedirect topics. Prompt identification of egr is essential, as the rash often precedes the diagnosis of malignancy by several months. Erythema gyratum repens like eruption erythema gyratum repens like appearance in pemphigus foliaceus.
Annular erythema primary care dermatology society uk. A patient with erythema gyratum repens egr had a marked increase of his eruption, with uncontrollable pruritus that was unresponsive to steroid therapy. Erythema gyratum repens egr is a rare disease characterized by the cutaneous eruption of migratory concentric erythematous bands. Erythema gyratum repens also known as gammels disease is a figurate erythema that is rapidly moving and usually a marker of underlying cancer. Erythema gyratum repens like appearance in pemphigus foliaceus. This case report details the appearance, epidemiology, diagnosis, and treatment of egr. Tender, bright red, slightly elevated nodules develop along the shins.
Annular erythema is not a diagnostic term but rather a description of a spreading erythematous eruption with an annular ringshaped appearance. A metastatic, undifferentiated adenocarcinoma was removed following a. Erythema gyratum repens like eruption occuring in resolving psoriasis during methotrexate therapy. According to medscape, fewer than 100 cases are found in medical literature. Erythema gyratum repens is a rare facultative cutaneous paraneoplasia.
While there are many dermatoses that have an annular appearance, the term annular erythema is sometimes reserved for a group of. Erythema anulare centrifugum eac, is a descriptive term for a class of skin lesion presenting redness in a ring form anulare that spreads from a center centrifugum. Leukocytoclastic vasculitis presenting as an erythema gyratum repens like eruption on a patient with systemic lupus erythematosus. There are many types of erythema, or conditions causing rash and reddening of the skin, but erythema gyratum repens typically appears because of an underlying condition. Volume 47, issue 5, supplement, november 2002, pages s254s256. Erythema gyratum repens is a figurate erythema that is rapidly moving and usually a marker of underlying cancer.
It is common in young people between 1220 years of age. Erythema annulare centrifugum erythema marginatum erythema migrans erythema gyratum repens. In common with all previous reports, both were found to have a hitherto unsuspected underlying neoplasm, one having an adenocarcinoma of the bladder and the other a prostatic carcinoma. A case studied with immunofluorescence, immunoelectronmicroscopy and immunohistochemistry. Erythema gyratum repens egr is a rare, and characteristic, rash strongly associated with malignancy.
It can be caused by a variety of conditions, and typically resolves spontaneously within 30 days. The eruption is rapidly migrating and composed of concentric rings forming a woodgrain pattern histology of erythema gyratum repens. Cd4cd8 doublenegative mycosis fungoides mimicking erythema gyratum repens in a patient with underlying lung cancer. A computed tomographic scan revealed a pulmonary mass measuring 59 by 43 mm panel b. If the expansion of the rash is not uniform it may become arciform arclike or polycyclic two or more connected rings. Erythema gyratum repens eruption has been noted after surgery, chemotherapy, or radiotherapy. Erythema gyratum repens is associated with malignancy in as many as 80% of patients. Following the resection, the skin lesions cleared within a few days. A 73yearold woman presented with an evolving pruritic, erythematous rash and was.
Erythema gyratum repens associated with anal cancer list of authors. Erythema nodosum en, is an inflammatory condition characterized by inflammation of the fat cells under the skin, resulting in tender red nodules or lumps that are usually seen on both shins. An erythema gyratum repens variant of bullous lupus. Erythema gyratum repens egr is a figurate erythema that is believed to be a paraneoplastic process. Erythema gyratum repens egr is an uncommon condition defining a type of skin lesion pattern, in which red skin rashes composed of concentric rings annular erythema moves. How and why the condition occurs is unknown, although it is thought it.
Leukocytoclastic vasculitis presenting as an erythema. Many different terms have been used to classify these types of lesions and it is still controversial on what exactly defines eac. Erythema gyratum repens egr is rare, and the primary lesion is a serpiginous macular, occasionally popular, erythema 210. Serrao v, martins a, ponte p, baptista j, apetato m, feio ab. Erythema gyratum repens with pulmonary tuberculosis. Erythema gyratum repens is rare and is the most distinctive of the gyrate erythemas. Pdf erythema gyratum repenslike eruption occuring in. Most patients with erythema gyratum repens develop the eruption. Erythema gyratum repens with associated squamous cell carcinoma of the lung. Various erytematous eruptions with a curvilinear gyrate appearance. Nevertheless, a diagnosis of erythema gyratum repens warrants an in depth search for possible underlying malignancies.
Repens repercolation repercussion repercussive repetabs repetat. Bullous lupus erythematosus is an autoantibodymediated subepidermal blistering disease that occurs in patients with systemic lupus erythematosus sle. In addition to other features, characteristic concentric erythematous bands forming a woodgrain appearance help distinguish erythema gyratum repens from other figurate erythemas, such as erythema annulare centrifugum, erythema migrans, and e. Neutrophilic dermatosis, bullous dermatoses, and systemic lupus erythematous gyratum repens 3. Listen to the audio pronunciation of erythema gyratum repens on pronouncekiwi. Erythema gyratum repens wikimili, the free encyclopedia. The condition, first described by gammel in 1952, is also referred to as gammels disease. In about of cases the disease is not tumorassociated. Histological features of erythema gyratum repens are not diagnostic and include hyperkeratosis, parakeratosis, acanthosis and.
Erythema gyratum repens as a manifestation of drug reaction with eosinophilia and systemic symptoms. Sarita sasidharanpillai 1, saleem rahima 1, manikoth payyanadan binitha 1, ettapurath n abdul latheef 1, aparna govindan 2, dhanya prashant 3, rajwa rahman 1. Erythema gyratum repens egr, first described by gammel,1 in 1952, is a rare paraneoplastic syndrome typically associated with an underlying malignancy. Erythema gyratum repens has not previously been described in association with non. Eritrodermia exfoliativa pdf english translation, synonyms, definitions and usage examples of spanish word eritrodermia exfoliativa. Erythema gyratum perstans information including symptoms, causes, diseases, symptoms, treatments, and other medical and health issues.
Among visceral malignancies, the lung is the most common site, 7, 8, 9 followed by the breast, urinary bladder, uterus andor cervix, gi tract stomach, and prostate. Erythema gyratum repens egr, considered one of the most specific cutaneous paraneoplastic phenomena, is characterized by a serpiginous morphology and a migrating scaly border. In addition, there is some types of gyrate erythema could be misdiagnosed as egr such as. Erythema gyratum article about erythema gyratum by the. A clinical diagnosis of erythema gyratum repens was made. A cavitating mass at the right lung apex was resected and proved to be tuberculous. Initial symptoms can be uncharacteristic, wood grain pattern lesions develop only in mature stages. Erythema gyratum repens like eruptions with large cell transformation in a patient with mycosis fungoides. Erythema gyratum repens is not an obligate paraneoplastic disease.
Erythema gyratum definition of erythema gyratum by. Erythema gyratum repens as a manifestation of drug. Erythema gyratum repens egr is a rare and characteristic, paraneoplastic rash associated with a variety of malignancies, most notably lung, esophageal, and breast cancers. In the majority of instances cancer is the culprit, however, certain autoimmune diseases or infections may give rise. Erythema nodosum is often associated with systemic diseases such as tuberculosis and rheumatic fever. Erythema gyratum repens wikipedia republished wiki 2. The most common include lung carcinoma, oesophageal carcinoma and breast carcinoma. Erythema gyratum repens induced by pegylated interferon. Most of the body is covered in numerous serpiginous bands arranged in. Erythema gyratum repens has also been associated with anal cancer. Thank you for helping build the largest language community on the internet. Erythema gyratum repens is a figurate erythema that is rapidly moving and usually a marker of underlying cancer, 1 2 3. Erythema gyratum repens with metastatic adenocarcinoma.