erythema elevatum diutinum - HEALTHY
Erythema elevatum diutinum (EED) is a rare, chronic vasculitis primarily affecting the skin and occasionally presenting with ocular manifestations. Characterised by well‐demarcated red to violaceous ... Crocker and Williams described and coined erythema elevatum diutinum (EED) in 1894 (Crocker & Williams, 1894).
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EED is characterized by the presence of a leukocytoclastic vasculitis, a feature that is ... Besides sarcoidosis, the differential diagnosis includes cutaneous T-cell lymphoma (mycosis fungoides), psoriasis, drug eruption, lupus erythematosus, erythema elevatum diutinum, granuloma annulare, ... Skin nontumor Dermal perivascular and vasculopathic reaction patterns Erythema elevatum diutinum Author: Kiran Motaparthi, M.D. Editor-in-Chief: Debra L.
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Zynger, M.D. Erythema elevatum diutinum: Early lesions show leukocytoclastic vasculitis in the upper to mid dermis composed by a neutrophilic infiltrate with some eosinophils (Am J Dermatopathol 2005;27:397) Progression of the lesions show involvement of the papillary and periadnexal dermis Dermal perivascular and vasculopathic reaction patterns: actinic (solar) purpura (pending) arthropod bites atrophic papulosis cutaneous vasculitis dermal hypersensitivity reaction erythema annulare centrifugum erythema migrans erythema elevatum diutinum granuloma faciale gyrate erythema Jessner lymphocytic infiltration of skin livedoid ... Differential diagnosis Erythema elevatum diutinum: More prominent fibrosis in late lesions Often paucicellular inflammatory infiltrate in late lesions Few plasma cells Fewer eosinophils (J Cutan Pathol 2011;38:876) Generally papules and nodules on backs of hands, extensor surfaces of extremities, buttock and trunk Cutaneous IgG4 related disease: Erythema elevatum diutinum is a vasculitic process presenting with papules / nodules on extensor surfaces with histologic features similar to leukocytoclastic vasculitis and onion skin fibrosis. Histologically resembles late stage erythema elevatum diutinum (EED) but has a different clinical presentation Erythemaotous nodules on lower limbs Dense concentric and lamellar fibrosis, foci of neutrophilic dust, sparse infiltrate of histiocytes, neutrophils, eosinophils and lymphocytes No granulomas present; no involvement of subcutaneous fat Pyoderma gangrenosum: has ulcer, no leukorrhexis Rheumatoid neutrophilic dermatitis, neutrophil rich variant of anaplastic large cell lymphoma Presence of fibrinoid vascular changes distinguishes necrotizing vasculitis such as leukocytoclastic vasculitis, erythema elevatum diutinum and granuloma faciale from Sweet syndrome Granuloma faciale: form of leukocytoclastic vasculitis, Grenz zone Erythema elevatum diutinum Granuloma faciale: form of leukocytoclastic vasculitis, Grenz zone Erythema elevatum diutinum Occlusive vasculopathy: fibrin thrombi filling venules and capillaries Contributed by Carina Dehner, M.D., Ph.D. Fibrinoid material within vessels