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American Family Physician Jul 2019Erythema multiforme is an immune-mediated reaction that involves the skin and sometimes the mucosa. Classically described as target-like, the erythema multiforme lesions... (Review)
Review
Erythema multiforme is an immune-mediated reaction that involves the skin and sometimes the mucosa. Classically described as target-like, the erythema multiforme lesions can be isolated, recurrent, or persistent. Most commonly, the lesions of erythema multiforme present symmetrically on the extremities (especially on extensor surfaces) and spread centripetally. Infections, especially herpes simplex virus and Mycoplasma pneumoniae, and medications constitute most of the causes of erythema multiforme; immunizations and autoimmune diseases have also been linked to erythema multiforme. Erythema multiforme can be differentiated from urticaria by the duration of individual lesions. Erythema multiforme lesions are typically fixed for a minimum of seven days, whereas individual urticarial lesions often resolve within one day. Erythema multiforme can be confused with the more serious condition, Stevens-Johnson syndrome; however, Stevens-Johnson syndrome usually contains widespread erythematous or purpuric macules with blisters. The management of erythema multiforme involves symptomatic treatment with topical steroids or antihistamines and treating the underlying etiology, if known. Recurrent erythema multiforme associated with the herpes simplex virus should be treated with prophylactic antiviral therapy. Severe mucosal erythema multiforme can require hospitalization for intravenous fluids and repletion of electrolytes.
Topics: Erythema Multiforme; Humans
PubMed: 31305041
DOI: No ID Found -
Clinics in Dermatology 2021Skin erythema may present owing to many causes. One of the common causes is prolonged exposure to sunrays. Other than sun exposure, skin erythema is an accompanying sign... (Review)
Review
Skin erythema may present owing to many causes. One of the common causes is prolonged exposure to sunrays. Other than sun exposure, skin erythema is an accompanying sign of dermatologic diseases, such as psoriasis and acne. Quantifying skin erythema in patients enables the dermatologist to assess the patient's skin health. Quantitative assessment of skin erythema has been the focus of several studies. The clinical standard for erythema evaluation is visual assessment; however, this standard has some deficiencies. For instance, visual assessment is subjective and ineffectual for precise color information exchange. To overcome these limitations, in the past three decades various methodologies have been developed in an attempt to achieve objective erythema assessments, such as diffuse reflectance spectroscopy and both optical and nonoptical systems. This review considers the studies published during the past three decades and discusses the performance, the mathematical tactics for computation, and the limited capabilities of erythema assessment techniques for cutaneous diseases. The achievements and limitations of the current techniques in erythema assessment are presented. The advantages and development trends of optical and nonoptical methods are presented to make the reader aware of the present technological advances and their potential for dermatological disease research.
Topics: Erythema; Humans; Psoriasis; Skin; Skin Pigmentation
PubMed: 34809765
DOI: 10.1016/j.clindermatol.2021.03.006 -
Cutis Apr 2023Erythema ab igne (EAI) is a skin condition caused by chronic heat-induced damage. The rash usually progresses over weeks to months of repeated or prolonged exposure to... (Review)
Review
Erythema ab igne (EAI) is a skin condition caused by chronic heat-induced damage. The rash usually progresses over weeks to months of repeated or prolonged exposure to subthreshold-intensity infrared radiation that is not hot enough to cause a burn. The diagnosis is clinical based on patient history and physical examination, but a biopsy can reveal dilated vasculature, interface dermatitis, and pigment incontinence. Erythema ab igne initially was described in association with patients cooking over wood-fire stoves but has been shown over the decades to have a variety of causes. Herein, we describe various etiologies of EAI, including new heat-producing technologies, cultural practices, psychiatric illnesses, and even iatrogenic causes. However, the cause most commonly is application of heat for treatment of chronic pain, which may be a diagnostic clue for an underlying chronic illness. Although there are no current US Food and Drug Administration-approved therapies for treatment of EAI hyperpigmentation, the prognosis is excellent because removal of the heat source often will result in spontaneous resolution over time. Finally, chronic EAI rarely has been reported to evolve into squamous cell carcinoma, poorly differentiated carcinoma, cutaneous marginal zone lymphoma, and even Merkel cell carcinoma.
Topics: Humans; Erythema; Erythema Ab Igne; Skin; Hyperpigmentation; Skin Neoplasms; Hot Temperature
PubMed: 37289686
DOI: 10.12788/cutis.0771 -
Dermatologic Clinics Jan 1985The gyrate erythemas consist of a nonspecific group (often called erythema annulare centrifugum) for which the cause is usually unknown, and three specific types... (Review)
Review
The gyrate erythemas consist of a nonspecific group (often called erythema annulare centrifugum) for which the cause is usually unknown, and three specific types (erythema marginatum rheumaticum, erythema chronicum migrans [Lyme disease], and erythema gyratum repens). The first specific type, erythema marginatum rheumaticum, has become extremely rare with the decline of its associated disease, rheumatic fever. The second specific type, erythema chronicum migrans, is caused by a spirochete transmitted by the I. ricinus complex of ticks. The third specific type, erythema gyratum repens, is uncommon, morphologically distinctive, and an indicator of serious disease, usually internal malignancy, in almost every instance.
Topics: Anti-Bacterial Agents; Arthritis; Erythema; Humans; Lyme Disease; Rheumatic Fever; Rheumatology
PubMed: 3912086
DOI: No ID Found -
European Journal of Pediatrics Nov 2023Erythema ab igne is a dermatological condition resulting from repeated low-grade heat exposure (below the burning point), which can variably manifest with reticulated... (Review)
Review
UNLABELLED
Erythema ab igne is a dermatological condition resulting from repeated low-grade heat exposure (below the burning point), which can variably manifest with reticulated erythema and skin hyperpigmentation. Not infrequently, the cause of such a skin disorder is not immediately evident or reported by patients, especially if these are children. Compared to adults, erythema ab igne is rare in children and, if the general practitioners and pediatricians are not aware of this disorder, pediatric patients are often addressed to rheumatologists and/or undergo useless immunological investigations. Here, we performed a systematic case-based review, which finally included 32 cases of pediatric erythema ab igne (in addition to our new clinical report), and discussed the main clinical aspects and issues of this clinical entity in children. In detail, similarities of erythema ab igne with livedo reticularis and/or vasculitis-related rashes sometimes can lead to perform a panel of immunological investigations, which could be avoided. Indeed, our analysis emphasizes the importance of a careful and complete patient's anamnesis, including active questioning about the potential exposure to any physical agents (including heat sources) that may cause dermatological lesions. We also highlight some peculiarities in terms of location and heat injury in children developing erythema ab igne, based on the presence or absence of comorbidities.
CONCLUSION
The occurrence of erythema ab igne in children (and especially in adolescents) is likely to increase in the next years because of the greater and sometimes inappropriate use of technological devices. Physicians should be aware of this condition in order to prevent patients from useless investigations, especially in the differential diagnosis of rheumatic disorders. A careful and complete patient's history with active questioning about the potential exposure to heating source is often decisive to diagnose erythema ab igne.
WHAT IS KNOWN
• Erythema ab igne is a dermatological condition which is mainly described in adults exposed to heating source at the workplace.
WHAT IS NEW
• The occurrence of erythema ab igne in children is likely to increase in the next years because of the greater and sometimes inappropriate use of technological devices. • Erythema ab igne in children can be classified in two main categories, based on the presence or absence of comorbidity. • A careful and complete anamnesis (including the active questioning about potential exposure to any heating source) is the mainstay for diagnosing erythema ab igne in children.
Topics: Adult; Adolescent; Humans; Child; Erythema Ab Igne; Erythema; Hyperpigmentation; Diagnosis, Differential; Hot Temperature
PubMed: 37661206
DOI: 10.1007/s00431-023-05155-1 -
Journal of Clinical Rheumatology :... Aug 2020
Topics: Diagnosis, Differential; Erythema; Humans
PubMed: 30059411
DOI: 10.1097/RHU.0000000000000875 -
JAMA Dermatology Jan 2021
Topics: Abdominal Wall; Adolescent; Burns; Erythema; Female; Humans; Skin
PubMed: 33206123
DOI: 10.1001/jamadermatol.2020.3995 -
The American Journal of the Medical... May 2001Erythema gyratum repens is a rare, clinically specific, and distinctive paraneoplastic syndrome. It is associated with internal malignancy in 82% of patients. (Review)
Review
BACKGROUND
Erythema gyratum repens is a rare, clinically specific, and distinctive paraneoplastic syndrome. It is associated with internal malignancy in 82% of patients.
OBJECTIVE
A 58-year-old man with erythema gyratum repens is described. On diagnosis of his eruption, a malignancy work-up revealed a 9-mm pulmonary adenocarcinoma. Removal of the carcinoma resulted in clearing of the erythema.
RESULTS
Erythema gyratum repens is most commonly associated with bronchial, esophageal, and breast cancer. It has also rarely been reported in patients without evidence of malignancy. The histopathologic findings are nonspecific. Direct immunofluorescence has sometimes revealed C3, C4, or immunoglobulin G at the basement membrane zone.
CONCLUSION
The etiology of erythema gyratum repens is unknown, although an immune response is postulated. Treatment involves treating the underlying malignancy.
Topics: Erythema; Female; Humans; Lymphocytes; Male; Middle Aged; Sex Ratio; White People
PubMed: 11370793
DOI: 10.1097/00000441-200105000-00002 -
BMJ (Clinical Research Ed.) May 2022
Topics: Blister; Communicable Diseases; Erythema; Exanthema; Female; Humans
PubMed: 35512796
DOI: 10.1136/bmj-2022-070355 -
American Journal of Clinical Dermatology 2007Palmar erythema (PE), an often overlooked physical finding, is due to several physiologic or systemic pathologic states. PE can exist as a primary physiologic finding or... (Review)
Review
Palmar erythema (PE), an often overlooked physical finding, is due to several physiologic or systemic pathologic states. PE can exist as a primary physiologic finding or as a secondary marker of systemic pathology. Primary or physiologic PE can be due to heredity, occurs in at least 30% of pregnant women as a result of associated alterations in the function of the skin and its microvasculature, or may be a diagnosis of exclusion (i.e. idiopathic PE). Secondary PE from systemic pathology encompasses a wide range of disease states. Twenty-three percent of patients with liver cirrhosis, from varying causes, can manifest PE as a result of abnormal serum estradiol levels. Patients with a rare neonatal liver disease such as Wilson disease and hereditary hemochromatosis may exhibit PE along with the other systemic manifestations of the genodermatoses. PE has been reported to occur in >60% of patients with rheumatoid arthritis and is associated with a favorable prognosis. Up to 18% of patients with thyrotoxicosis and 4.1% of patients with diabetes mellitus can have PE. This cutaneous manifestation of diabetes occurs more often than the more classic diseases such as necrobiosis lipoidica diabeticorum (0.6%). PE can be seen in early gestational syphilis and among patients with human T-lymphotrophic virus-1-associated myelopathy. Drug-induced PE with hepatic damage has been documented with use of amiodarone, gemfibrozil, and cholestyramine, while topiramate and albuterol (salbutamol) have been reported to cause PE in the setting of normal liver function. Fifteen percent of patients with both metastatic and primary brain neoplasms may have PE. Increased levels of angiogenic factors and estrogens from solid tumors have been postulated as the cause of PE in such cases. Erythema ab igne can mimic PE, and patients with atopic diathesis are more likely to have PE than matched control subjects. Smoking and chronic mercury poisoning are environmental causes of PE.No treatment of primary PE is indicated. If medication is the cause of PE, the drug responsible should be discontinued if possible. Identification of PE related to underlying disorders should be followed by treatment of the underlying condition. In light of the numerous etiologies of PE, this article reviews the current literature and provides a framework to help guide the clinician in determining the cause of PE in patients presenting with this finding.
Topics: Erythema; Hand; Humans
PubMed: 18039017
DOI: 10.2165/00128071-200708060-00004