Eritema elevatum diutinum como diagnóstico diferencial das doenças reumatológicas: relato de caso

Abstract

Erythema elevatum diutinum is a chronic and rare cutaneous leukocytoclastic vasculitis, characterized by red, purple and yellow papules, plaques and nodules, distributed symmetrically on the extensor surfaces of the limbs. It is associated with several autoimmune, neoplastic and infectious processes, mainly hematological malignancies in about 30% of the cases. Joint pain and arthritis are frequent symptoms, affecting approximately 40% of the patients, indicating the need for its inclusion in the differential diagnosis of rheumatic diseases, chiefl y the other presentations of leukocytoclastic vasculitis, which are characterized by the combination of rheumatic manifestations and peculiar cutaneous lesions. We report the case of an 18-year-old female patient who developed erythema elevatum diutinum and whose diagnosis was based on the morphologic characteristics, the distribution pattern of the cutaneous lesions and the histopathological fi ndings of leukocytoclastic vasculitis. The major systemic symptom was severe arthritis.

Erythema elevatum diutinum

“…In cases resistant to this drug, colchicine, systemic, intralesional, and high potency topical corticosteroids, sulfapyridine, and niacinamide combined to tetracycline can be tried. 1 , 5 Residual hyperpigmentation with occasional atrophy is common after regression of the lesions. 3 …”

“…4 The lesions have an initial soft consistency, that becomes hardened during their course due to fibrosis. 5 …”

“…It is believed that there is a stabilization in the lysosomes of the neutrophils or a modification in the deposits of complement (C3). 5 EED tends to have a chronic course, despite reports of spontaneous involution after a period that ranges from 5 to 10 years. 1 , 4 Residual hyperpigmentation with occasional atrophy is common with the regression of the lesions.…”

Construction of concept map on the physiotherapeutic evaluation in the rheumatic patients: an experience report

“…They require interventions associated with lifestyle changes, in a process of continuous care that does not always lead to cure. (8,9) Among the most common chronic diseases are rheumatic diseases, which are expressed with numerous characteristics, thus requiring a more detailed evaluation. In rheumatology, given the systemic conditions that the patient presents, it is important for the physiotherapist to clearly determine the patient's involvement.…”