Which skin findings are characteristic of erythema annulare centrifugum (EAC)?

Updated: Mar 06, 2020
  • Author: Dirk M Elston, MD; Chief Editor: William D James, MD  more...
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Pertinent physical findings of erythema annulare centrifugum (EAC) are usually limited to the skin, but a full physical examination should be conducted to assess for an underlying systemic process.

Skin findings are as follows:

  • Primary lesion: The eruption begins as erythematous papules that spread peripherally while clearing centrally. These lesions enlarge at a rate of approximately 2-5 mm/d to produce annular, arcuate, figurate, circinate, or polycyclic plaques, as shown in the images below. The margin, which is usually indurated, varies in width from 4-6 mm, and, often, a trailing scale is present on the inner aspect of the advancing edge. The diameter of the polycyclic lesions varies from a few to several centimeters. Vesiculation may be present. Note the images below.
  • Arcuate lesions of erythema annulare centrifugum d Arcuate lesions of erythema annulare centrifugum demonstrate minimal scale.
  • Superficial erythema annulare centrifugum demonstr Superficial erythema annulare centrifugum demonstrates a central clearing and trailing scale behind an advancing, annular, erythematous border.
  • Distribution: Lesions demonstrate a predilection for the thighs and the legs, but they may occur on the upper extremities, the trunk, or the face. The palms and the soles are spared.
  • Color: The lesions are pink to red with central clear areas. Occasionally, residual hyperpigmentation of dull red, brown, or violet is present. A case of EAC associated with hyperbilirubinemia and jaundice secondary to choledocholithiasis has been reported.

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