Gyrate erythemas

    • A group of disorders characterized clinically by one to several circinate, arcuate or polycyclic lesions that may be fixed or migratory
    • Histologically, there is a tight perivascular lymphohistiocytic infiltrate ("cuffing") which may involve the vessel wall ("lymphocytic vasculitis")
    • The various entities in this group are subcategorized into two groups, depending upon whether the perivascular infiltrates are superficial only or both superficial and deep.
    • Because of considerable overlap and nonspecificity of features, precise histologic classification is not always possible, and the diagnosis often rests upon a combination of clinical and histologic findings.
    • Specific disease entities in in the group of gyrate erythemas include: erythema annulare centrifugum, erythema gyratum repens, erythema marginatum, annular erythemas of infancy and erythema chronicum migrans.

    Erythema annulare centrifugum:

    Clinical Features:

    • Large, annular scaly plaques, most commonly on the trunk of adults
    • May be idiopathic or secondary to a variety of conditions such as infections, autoimmune diseases, drugs or neoplasia.

    Histologic Features:

    • Superficial variant (more common):
      • Spongiosis with exocytosis and parakeratosis and papillary dermal edema 
      • Sharply demarcated superficial perivascular lymphocytic inflammation ("coat sleeve" or "cuffing")
    • Superficial and deep variant:
      • Normal epidermis
      • Lymphocytes "cuff" both superficial and deep blood vessels.

    Cases associated with this book:

  • Erythema annulare centrifugum
    Author: Stephen Lyle, M.D., Ph.D.

    Conference: Teaching Collection
  • Gyrate erythema
    Author: Stephen Lyle, M.D., Ph.D.

    Conference: Teaching Collection