Which conditions should be included in the differential diagnoses 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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Answer

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]

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