erythema elevatum dilutinum
Last reviewed 01/2018
- 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.
- 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
- 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.