Erythema marginatum
Erythema marginatum | |
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Painting of a leg with erythema marginatum | |
Specialty | Dermatology |
Erythema marginatum (also known as chicken wire erythema)[1] is an acquired skin condition which primarily affects the arms, trunk, and legs.[2] It is a type of erythema (redness of the skin or mucous membranes) characterised by bright pink or red circular lesions which have sharply-defined borders and faint central clearing. The lesions typically range from 3 to 10 cm in size, and are distributed symmetrically over the torso and inner surfaces of the limbs and extensor surfaces.[3] The lesions last between one and four weeks but have been known to be present on patients for as long as several months.[4]
The condition was first reported in 1816 by Jean Cruveilhier and is thought to be linked to other skin conditions such as urticaria and systemic lupus erythematosus.
An association with bradykinin has been proposed in the case of hereditary angioedema.[5]
Presentation
The rings are barely raised and are non-
The condition is characterised by circular, non-pruritic, erythematous rashes which form on the trunk and extremities of the body. The rash has a known serpiginous edge, and often appears and disappears spontaneously over time.[6] Histological examination of the rash identifies infiltration of mononuclear cells and neutrophils in the papillary and upper half of the reticular dermis layer.[7]
Associated conditions
It occurs in less than 10% of patients with acute
It is an early feature of acute rheumatic fever though not pathognomonic of it.[11] It some cases it may be associated with mild myocarditis (inflammation of heart muscle).
The condition is also seen as a precursor to or accompany an attack of angioedema,[1] and is seen in conditions like allergic drug reactions, sepsis and glomerulonephritis.[11]
It often occurs as a harbinger of attacks in hereditary angioedema. In this case it may occur several hours or up to a day before an attack.[citation needed]
Diagnosis
Types
Some sources distinguish between the following:[citation needed]
- "Erythema marginatum rheumaticum"
- "Erythema marginatum perstans"
The diagnosis of erythema marginatum can be made during examination of skin appearance. A skin biopsy may be performed if needed, to confirm the diagnosis. Medical history and family history may also be taken into account.
Treatment
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Erythema marginatum can be treated with hydrocortisone and adrenocorticotropc hormone (ACTH).[12]
In cases where the condition is associated with ARF and severe carditis, corticosteroids are indicated
References
- ^ ISSN 1651-2057.
- ^ Hinzey, E (June 2023). Arredondo M (ed.). "Erythema Marginatum". Patient Education Reference Center (PERC).
- ^ "erythema marginatum" at Dorland's Medical Dictionary
- ISBN 978-1-4160-2999-1.
- S2CID 38676096.
- ^ Kliegman, R.M.; Stanton, B.F; Gerne, J.W.; Schor, N.F.; Behrman, R.E. (2011). Group A streptococcus. In: Nelson textbook of pediatrics (9 ed.). Elsevier Saunders.
- ISSN 0022-3476.
- ISSN 0974-7559.
- ^ Tani, L.T.; Veasy, L.G.; Minich, L.L.A.; Shaddy, R.E. (2003). "Rheumatic fever in children younger than 5 years: is the presentation different?". Pediatrics. 112: 1065–8.
- ISBN 9781451153453.
- ^ a b Erythema Marginatum Pictorial CME
- PMID 13249623.
- ISBN 9780781737708.
- ISBN 978-1-61002-521-8.