- 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:
- 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.
- 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.