An observational study of the efficacy of azithromycin in erythema annulare centrifugum

Abstract

Erythema annulare centrifugum (EAC) is a form of figurate erythema consequent to a cutaneous hypersensitivity reaction to an underlying agent. In the present study, we aimed to assess the role of oral azithromycin in cases of idiopathic EAC. We performed an open trial of azithromycin in 10 patients with idiopathic EAC. Histopathological examination of biopsies was performed to exclude any alternative diagnosis and to assess the depth of the infiltrate. Patients were administered oral azithromycin 250 mg once daily until clinical resolution of the disease, and followed up regularly to monitor for possible relapse. Histopathological examination of the 10 biopsies revealed superficial pattern in 3, deep pattern in 2 and mixed pattern in the remaining 5. Of the 10 patients, 8 responded to azithromycin 250 mg, with no relapse during follow-up. Oral azithromycin might be a promising therapy in cases of idiopathic EAC. Cases with a superficial pattern respond earlier than cases with a deep pattern.

Recurrent Erythema Annulare Centrifugum due to Influenza Type A

“…However, a patient with a variant form of EAC showed relapse during many years for no apparent reason [8, 9]. The therapeutic validity of macrolides, especially clarithromycin, was demonstrated in cases of idiopathic EAC [10] and clarithromycin resulted in efficacy also in our challenging case. EAC secondary to influenza A in a dark-skinned woman was never described in this condition.…”

Tocilizumab-Induced Erythema Annulare Centrifugum

“…Furthermore, a perivascular infiltrate in both superficial and deep dermis would point toward a clinical picture more typical of the deep variant of EAC [ 2 ]. Possible explanations for such discordance could include the existence of a mixed pattern, with only 3 cases described in the literature [ 9 ], and sampling issues such as biopsy timing or location.…”

Refractory erythema annulare centrifugum treated with apremilast

“…There is also limited evidence for the use of calcipotriene, tacrolimus, narrow-band UV-B, fluconazole, oral metronidazole, and subcutaneous interferon-alpha. 2 , 3 , 4 , 5 …”