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Indian Pediatr 2012;49: 772 |
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Multiple Annular Erythematous Lesions with
Trailing Scale
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Avijit Mondal, *Piyush Kumar and #Rajesh Kumar Mandal
Departments of Dermatology, College of Medicine and
JNM Hospital, Kalyani, Nadia; *Katihar Medical College, Katihar,
Bihar and #North Bengal Medical College.
Email: [email protected]
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A 6-year-old boy presented with recurrent pruritic scaly
lesions all over trunk for last 2 years. These lesions
appeared spontaneously and resolved in 4-8 weeks without any
sequale. Rest of the history was non-contributory and no
other family member was having similar lesions. On
examination, multiple, annular erythematous lesions with
trailing scale at the inner border were present on trunk (Fig.
1). Few annular lesions were found on tongue too. On
enquiry, tongue lesions used to appear and disappear
simultaneously with trunk lesions. Palm, sole, nail, scalp
and other mucosa were unremarkable. Routine investigations
and KOH mount did not reveal any abnormality. Clinically,
the child was diagnosed as Erythema annulare centrifugum
(EAC). Histopathological findings were consistent with the
diagnosis. Involvement of tongue is very rare. The incidence
of disease peaks in the fifth decade.
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Fig.1 Mutiple annular
erythema with trailing scale at inner border.
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Erythema annulare centrifugum (EAC) is
the most common figurate erythema and is characterized by
solitary or multiple, annular or polycyclic lesions that
grow slowly (2-3 mm/day); with a trailing scale at the inner
border of the annular erythema. The majority of cases are
idiopathic; some association with dermatophytosis,
infections, drugs, foods (tomato) and malignancy have been
noted. The differential diagnosis includes those conditions
that can have annular configuration and includes tinea,
granuloma annulare, secondary syphilis, subacute cutaneous
lupus erythematosus, erythema marginatum, erythema migrans,
annular urticaria, and mycosis fungoides. The "trailing
scale at inner border" of EAC is diagnostic. Most cases
subside spontaneously.
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