Jump to content
In this section we have spot diagnoses posted on a daily basis since June 2010, now over 1700! You can review the archived cases and read the suggested diagnoses by users and the final comment by Dr Uma Sundram, the Editor-in-Chief and main spot diagnosis host. Case are uploaded each week day by 10 a.m. UK time with the correct diagnosis will generally be posted at 8 p.m. UK time. Why not view the most recent spot diagnosis and proffer a diagnosis?

Case Number : Case 1854 - 06 July - Dr Iskander Chaudhry (Invited) Posted By: Guest

Please read the clinical history and view the images by clicking on them before you proffer your diagnosis.
Submitted Date :
   (0 reviews)

60 year old female; recurrent lower limb rash. Annular discoid rash post thigh, left popliteal fossa and shin. Biopsy: right shin, incisional biopsy.

Edited by Admin_Dermpath


  Report Record

User Feedback


Saman Fatah

Posted

Elegant example of Eosinophilic Annular Erythema!

Share this comment


Link to comment
share_externally

Anil Patki

Posted

Erythema annulare centrifugum, deep variety

Share this comment


Link to comment
share_externally

vincenzo polizzi

Posted

Tricky case. The pattern is of an erythema annulare centrifugum one. But edema or mucin in dermis? And there are more than occasional eosinophils.  

My spot is EAC-like drug reaction, for CPC, but consider a dermatomyositis or lupus tumidus also. 

Share this comment


Link to comment
share_externally

Cem Leblebici

Posted

I agree with the diagnosis of Eosinophilic Annular Erythema. 

Share this comment


Link to comment
share_externally

Raul Perret

Posted

The histological patter is that of a gyrate erythema, for me consistent with erythema annulare centrifugum

Share this comment


Link to comment
share_externally

Dr. Mona Abdel-Halim

Posted

Esinophils quiet frequent, esinophilic annular erythema is a good possibility. 

Share this comment


Link to comment
share_externally

vincenzo polizzi

Posted

I don’t know this entity, but after having read something about that,  fully agree, because clinical pathological findings fit a lot.  

Share this comment


Link to comment
share_externally

Robledo F. Rocha

Posted

I don't believe eosinophilic annular erythema is a real entity, but rather a figurate clinical presentation of Wells’ syndrome.

Likewise, I don't believe erythema annulare centrifugum is a real entity, but rather a reaction pattern triggered by many underlying factors, including drugs, helminthes, arthropods, hypereosinophilic syndrome, and other conditions in which eosinophils can be easily found. In the personal observation of A. Neil Crowson (from Barnhill's book), eosinophils are seen in roughly 10% to 20% of erythema annulare centrifugum cases, and in the so-called deep type of erythema annulare centrifugum, superficial and deep perivascular infiltrate without epidermal changes is the characteristic histological picture.

Having said that, and considering the interstitial mucin deposition and the interstitial inflammatory infiltrate, I favor figurate Wells’ syndrome.

Share this comment


Link to comment
share_externally

Admin_Dermpath

Posted

Many thanks for your thoughts on this case. The clinician felt that the rash was entirely in keeping with Eosinophilic Annular Erythema when she received the histology report back describing conspicuous number of eosinophils in the dermis!

As Robledo commented there is some discussion on the nosological relationship of this condition with Well’s syndrome but is likely a clinical and pathological polymorphism of Wells syndrome ;)

Erythema annulare centrifugum also appears on the thighs and legs with histopathology showing perivascular chronic lymphocytic infiltration. Eosinophils are not usually a feature.

 

Iskander 

Share this comment


Link to comment
share_externally



Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.

Guest
Add a comment...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

Loading...

×
×
  • Create New...