erythema annulare

Introduction

Introduction to ring erythema The erythemaannulare is a group of skin diseases characterized by ring-shaped or erythematous erythema. It is not an independent disease, but a dermal inflammatory reaction caused by various causes, that is, vasodilatation or cell infiltration on the skin. Performance. It usually includes simple retrograde erythema, eccentric annular erythema, claudication erythema, chronic migratory erythema, and rheumatic marginal erythema. The simple erythema erythematosus (erythemasimplexguratum) is an allergic vascular response, which is more common in young women. There are often respiratory infections before onset or onset several days before menstruation. The eccentric macular erythema (erythemaannulasecentrifugum) is an erythematous skin disease characterized by eccentricity extending to the periphery and characterized by multiple annular lesions and scaly. basic knowledge The proportion of illness: 0.002% Susceptible people: more common in women Mode of infection: non-infectious Complications: breast cancer ovarian cancer lung cancer uterine cancer

Cause

Ring erythema

(1) Causes of the disease

Allergic reaction (35%):

The cause is not fully understood, it may be rheumatism, chronic lesions (such as tonsillitis, sinusitis, otitis media, cholecystitis, gum abscess, tuberculosis, etc.), fungal infections (such as Candida albicans, penicillium, etc.), insect bites (such as niches) ), rickettsia, drugs (such as penicillin), food (such as moldy cheese) and allergic reactions caused by food-induced digestive tract dysfunction.

Immunity factor (27%):

Cyclic erythema may also be caused by autoimmunity caused by certain malignant tumors such as breast cancer, ovarian cancer, nasopharyngeal carcinoma, bronchial carcinoma or lung cancer, and malignant tumors of the central nervous system.

Endocrine factors (20%):

In addition, some people think that it is related to endocrine diseases (menstrual rash, goiter, diabetes, etc.) and autonomic dysfunction. Rheumatic annular erythema is often accompanied by active rheumatism. After children with Still disease have ring-shaped erythema, It is often suggested that there has been a heart attack.

The cause of erythema annulase centrifugum is a hypersensitivity reaction caused by a variety of causes, such as infection (virus, bacteria, fungi, parasites), drugs (penicillin, antimalarials), potential malignancy Disease, food (moldy cheese), endocrine changes (menstrual cycle) and cholelithiasis.

The erythema gyratum repens is an allergic reaction to the tumor tissue. The disease is rare and the cause is unknown.

The erythema simplex gyratum is an allergic vascular response.

(two) pathogenesis

Not fully understood, may be rheumatism, chronic lesions, fungal infections, insect bites, rickettsia, drug foods and food-induced gastrointestinal dysfunction caused by allergic reactions, or autoimmune caused by some malignant tumors, there are People think that it is related to endocrine diseases and autonomic dysfunction.

Prevention

Circular erythema prevention

Pay attention to skin hygiene, strengthen physical exercise and increase skin's resistance.

Once the cause is clear, appropriate treatment should be taken. In the case of an acute attack, bed rest should be avoided to avoid strenuous exercise.

Complication

Ring erythema complications Complications Breast cancer Ovarian cancer Lung cancer Uterine cancer

The erythema gyratum repens are associated with breast cancer, ovarian cancer, uterine cancer, lung cancer and central nervous system tumors.

Symptom

Ring erythema symptoms Common symptoms Itching papules edema edema erythema (border clear...

Simple retrograde erythema

More common in young women, often have respiratory infections before the onset or a few days before menstrual cramps, starting from a reddish papule, eccentrically expanded into a ring, bright red or reddish, a large number, sometimes rash is multi-ring, erythema The edge is narrow as a line. After 1 to 2 days, it can dissipate on its own, but it can be re-opened elsewhere. The skin lesions occur on the trunk and limbs. After the skin lesions subsided, no traces are left, no subjective discomfort, and sometimes it can be delayed for several months.

2. Eccentric ring erythema (erythema annulase centrifugum)

It is a erythematous skin disease characterized by eccentricity to the periphery and characterized by multiple ring-shaped lesions and scaly. It can be seen at any age, but it is more common in 30 to 50 years old, no gender difference, starting from single or multiple The edematous red papule gradually enlarges to the surrounding area, and the center gradually fades out. It is ring-shaped or curved. The old skin lesions can renew new skin lesions, so they have multiple rings or targets. The active edges can be expanded outwards every day. ~ 3mm, bulging like a bank, with white scales attached to the inner edge, occasionally small blisters and scar formation, mild rash, rash on the limbs, buttocks, facial is rare, can be divided into superficial and deep Type or Darier type, the latter lesions are strip-like, without scaly, chronic disease, can last for months or years, leave pigmentation after regression, easy to relapse, except for a few with cancer, generally The prognosis is good.

3. erythema gyratum repens

It is an allergic reaction to the tumor tissue. This disease is rare. It occurs in middle-aged women. The skin lesions mainly affect the trunk and the proximal part of the limbs. It is a generalized pruritic erythema. It looks like a pattern on a wooden board. Covered with small scales, the edge is 1 ~ 2cm wide, slightly higher, slowly eccentrically expanding outward, leaving pigmentation after retreat, mostly associated with breast cancer, ovarian cancer, uterine cancer, lung cancer and central nervous system tumors, nearby lymph nodes It is painless and swollen, and eosinophils in the blood can be increased. The course and prognosis of this disease are related to the nature and malignancy of the accompanying tumor.

Examine

Ring erythema check

The histopathology of eccentric annular erythema, the main change is the infiltration of dense sleeve-like lymphocytes around the blood vessels, eosinophils, occasionally neutrophils and mast cells, mild edema in the upper lining and epidermis of the dermis, It can be seen that the epidermis is mildly parakeratotic.

Histopathological manifestations of limp-like erythema were mild focal sponge formation, epidermal hyperplasia, vacuolar degeneration, and neutral and acidic granulocyte infiltration in the dermis.

Diagnosis

Diagnosis of annular erythema

Centrifugal annular erythema: can be diagnosed according to clinical manifestations and histopathology, the diagnosis of sacral retrograde erythema is not difficult, but the disease needs to be differentiated from the sputum, the latter has no similar erythema, no cell infiltration, positive for fungal examination.

Centrifugal annular erythema sometimes needs to be differentiated from body lice, lupus erythematosus, ring granuloma, pityriasis rosea, punctate psoriasis and mycosis fungoides. No similar erythema, no cell infiltration, positive for fungal examination.

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