Which medications have been used successfully in the treatment 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

Case reports have documented success in the treatment of EAC with drugs previously unreported to be useful for EAC. Note the following:

  • Hyaluronic acid: A 73-year-old man with an 11-week history of EAC that was associated with the onset of left knee osteoarthritis received injections of intra-articular hyaluronic acid that effected improvement of his osteoarthritis and resolution of his EAC. [30]
  • Calcipotriol: A case of EAC of 3 years' duration in a 73-year-old woman responded to calcipotriol after the patient did not respond to topical and systemic corticosteroids, antifungals, and psoralen with UV-A therapy. The eruption cleared completely after 3 months of treatment with calcipotriol. [42] One report also described EAC responding to combination calcipotriol and narrow-band UVB. [43]
  • Metronidazole: A 38-year-old man with a 2-year history of EAC for which an underlying cause could not be found and that failed to respond to systemic antibiotics (ie, ciprofloxacin, clarithromycin), antifungal agents (ie, itraconazole, terbinafine), and topical calcipotriol did respond to oral metronidazole. The drug had been given to treat papulopustular rosacea. His EAC was coincidentally found to resolve, as did his rosacea, after 1 month of therapy. No recurrence of EAC was noted after 1 year of follow-up. A possible causal relationship between rosacea and EAC was postulated in the report. [44]
  • Etanercept: A 57-year-old man with erythema annulare centrifugum, unsuccessfully treated previously with narrow-band UVB, topical steroids, and methotrexate, responded with complete resolution of his eruption after 4 weeks of therapy with etanercept at 25 mg SQ twice weekly. The erythema annulare centrifugum eruption recurred upon cessation of etanercept therapy and resolved again with resumption of therapy. [4]
  • Erythromycin: Eight patients with EAC in Kaohsiung Chang Gung Memorial Hospital (a tertiary referral medical center in Taiwan) were included in the study, All patients responded poorly to previous treatments, including topical steroids, oral antihistamines, and even systemic steroids. Oral erythromycin stearate at a daily dose of 1000 mg (250 mg 4 times a day) for 2 weeks was given to all patients. Three of the patients had recurrence of the disease and all lesions resolved after re-administration of erythromycin. These patients had more widespread lesions. It was concluded in the study that erythromycin can be an effective treatment option for EAC. [45]

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