The Neutrophilic Dermatoses

David Farhi, MD; Daniel Wallach, MD


Dermatology Nursing. 2008;20(4):274-282. 

In This Article

Erythema Elevatum Diutinum

Crocker and Williams described and coined erythema elevatum diutinum (EED) in 1894 (Crocker & Williams, 1894).

EED is characterized by the presence of a leukocytoclastic vasculitis, a feature that is typically absent in other ND.

EED typically presents with chronic infiltrated red or violaceous papules and plaques, which are often located on the extensor aspects of the four limbs (hands, feet, elbows, and knees), in a bilateral and symmetric pattern (see Figure 4). Acute lesions may appear bullous, necrotic, or hemorrhagic. Chronic lesions are yellowish or brown-infiltrated papules and plaques.

Figure 4.

Erythema elevatum diutinum

Skin pathology shows a dermal neutrophilic infiltrate, fibrin deposition, and a leukocytoclastic vasculitis.

Like SPD, EED is usually rapidly responsive to dapsone 100 mg daily. Refractory cases may be treated by oral steroids (Wilkinson, English, Smith, Wilson-Jones, & Winkelmann, 1992).


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