| New concepts on erythema annulare centrifugum: a clinical reaction pattern that does not represent a specific clinicopathological entity. | |
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MedLine Citation:
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PMID: 18721189 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Erythema annulare centrifugum (EAC) is considered an inflammatory skin disease with unknown aetiology. In most textbooks it is assigned to the incoherent conglomeration of figurate or gyrate erythemas. OBJECTIVES: To re-evaluate a large cohort of patients with EAC and to assess the evidence for infection with Borrelia. METHODS: We retrospectively investigated 90 cases with the diagnosis of EAC. Haematoxylin and eosin sections were re-examined and diagnoses were specified; these were then confirmed by clinicopathological correlation. Infection with Borrelia was assessed by focus-floating microscopy and by a Borrelia-specific polymerase chain reaction (PCR). RESULTS: Besides a miscellaneous group of annular disorders at times confused with EAC such as urticaria, leucocytoclastic vasculitis and psoriasis (20 of 90; 22%), EAC appeared to serve as a collective term for three main clinicopathological reaction patterns: (i) (tumid) lupus erythematosus (29 of 90; 32%), (ii) spongiotic dermatitides (25 of 90; 28%) and (iii) pseudolymphoma (16 of 90; 18%). In 13 of 16 (81%) cases with a pseudolymphomatous reaction pattern spirochaetes stained positive but were negative in other reaction patterns of EAC as well as in negative controls. These findings were confirmed by a Borrelia-specific PCR which was positive in two of three (67%) of these pseudolymphomatous EAC cases but was negative in all other variants of EAC (none of five) as well as 20 controls. CONCLUSIONS: We conclude that 'EAC' is a clinical reaction pattern that does not represent a specific clinicopathological entity and should lead to consideration of mainly lupus erythematosus, dermatitis and, in some cases, cutaneous Lyme disease. |
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Authors:
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M Ziemer; K Eisendle; B Zelger |
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Publication Detail:
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Type: Journal Article Date: 2008-08-20 |
Journal Detail:
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Title: The British journal of dermatology Volume: 160 ISSN: 1365-2133 ISO Abbreviation: Br. J. Dermatol. Publication Date: 2009 Jan |
Date Detail:
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Created Date: 2009-01-09 Completed Date: 2009-02-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0004041 Medline TA: Br J Dermatol Country: England |
Other Details:
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Languages: eng Pagination: 119-26 Citation Subset: IM |
Affiliation:
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Department of Dermatology and Venereology, Friedrich-Schiller-University, Jena, Germany. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Animals Borrelia / isolation & purification Borrelia Infections / pathology* Child Dermatitis / pathology* Diagnosis, Differential Erythema / pathology* Female Humans Immunohistochemistry Lupus Erythematosus, Cutaneous / pathology* Male Middle Aged Polymerase Chain Reaction Retrospective Studies Skin / pathology Ticks / microbiology Young Adult |
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