Diagnostic Considerations

Also consider the following:

Annular urticaria
Benign lymphocytic infiltrate
Erythema migrans: These lesions are typically less numerous, less circinate in configuration, and often accompanied by a history of a tick bite ( Ixodes scapularis).
Erythema gyratum repens: Erythema annulare centrifugum (EAC) can be distinguished from this condition by its slower rate of spread (weeks rather than days) and by its less bizarre configuration. Also, erythema gyratum repens is almost always associated with an underlying malignancy.
Erythema marginatum rheumaticum: This is a nonscaling gyrate erythema that by definition is found in association with rheumatic fever (10-18% of patients with rheumatic fever). The rate of spread is measurable in hours, and the skin infiltrate is neutrophilic as opposed to lymphohistiocytic.
Facial granuloma
Subacute cutaneous lupus erythematosus (annular variant): These lesions tend to coalesce and can be accompanied by central hypopigmentation and telangiectasias.
Syphilis: Cotterman et al report a case of syphilis mimicking erythema annulare centrifugum (as well as tinea imbricata) in an immunocompromised patient. ^[38]

Differential Diagnoses

Workup

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Media Gallery

Arcuate lesions of erythema annulare centrifugum demonstrate minimal scale.
Superficial erythema annulare centrifugum demonstrates a central clearing and trailing scale behind an advancing, annular, erythematous border.

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Author

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Michael J Wells, MD, FAAD Dermatologic/Mohs Surgeon, The Surgery Center at Plano Dermatology

Michael J Wells, MD, FAAD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Warren R Heymann, MD Head, Division of Dermatology, Professor, Department of Internal Medicine, Rutgers New Jersey Medical School

Warren R Heymann, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Received income in an amount equal to or greater than $250 from: Elsevier; WebMD<br/>Served as a speaker for various universities, dermatology societies, and dermatology departments.

Additional Contributors

Robert J Willard, MD Dermatologist and Mohs Surgeon, Private Practice, Dermatology and Mohs Surgery Center, PC

Robert J Willard, MD is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Surgery, American Society for Dermatologic Surgery

Disclosure: Nothing to disclose.

Andrew D Montemarano, DO Consulting Staff, The Skin Cancer Surgery Center

Andrew D Montemarano, DO is a member of the following medical societies: American Academy of Dermatology, American College of Mohs Surgery, American Society for Dermatologic Surgery, MedChi The Maryland State Medical Society

Disclosure: Nothing to disclose.

Marisel Peralta-Abejo, MD, DPDS Dermatology Consultant, Bulacan Primehealth Multi-Specialty Clinic, Meycauayan Doctors Hospital, and Valenzuela Citicare Medical Center

Marisel Peralta-Abejo, MD, DPDS is a member of the following medical societies: Philippine Dermatological Society

Disclosure: Nothing to disclose.

Erythema Annulare Centrifugum Differential Diagnoses

Diagnostic Considerations

Differential Diagnoses

References

Tables

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