Erythema annulare centrifugum: report of a case with neonatal onset

Abstract

Darier's erythema annulare centrifugum (EAC) is often associated with infectious, autoimmune or neoplastic disease, nevertheless, most cases of EAC remain unexplained. We report a case of EAC with neonatal onset and a clinical course of over 20 years. The patient presented from the 6th day of life with erythematous papules that enlarged centrifugally to form figurate, annular or policyclic plaques involving the entire cutaneous surface. The clinical picture had a chronic course, disappearing only during unrelated febrile episodes. Histologic examination revealed a normal epidermis and a dense perivascular lymphohistiocytic infiltrate and numerous eosinophils in the superficial and reticular dermis. Today the patient is 24 years old and his lesions are still unchanged. Recently, clinical evaluation revealed a diffuse sderodermic induration. A second biopsy showed a diffuse thickening of collagen fibers in the dermis. To our knowledge, this is the second report of EAC with neonatal onset and such a long and peculiar clinical course.

Neutrophilic Figurate Erythema of Infancy

“…Interestingly, our patient presented a complete resolution of the lesions only during febrile episodes. Such a phenomenon has been previously described by Wong et al in a patient suffering from AEI and by Guillet et al and Bottoni et al in patients suffering from EAC (20,22,23). It is possible that the patients suffering from annular erythemas, which are inflammatory dermatoses, have a dysregulation of cytokine production in the skin and so the natural increase of interferon (IFN) which usually occurs when body temperature is higher than normal may cause a normalization of such alteration, with resolution of the skin lesions.…”

An interesting case of coincidental epidermolytic hyperkeratosis and erythema annulare centrifugum in the setting of latent tuberculosis in a 12‐year‐old female

“…The prevalence and incidence of EAC are unknown. Adults are the most commonly affected population, but it may also occur in children, and a case of neonatal EAC was reported . Retrospective studies have shown that EAC ages of onset usually range from 5 to 90 years, with a mean age of onset of 40–50 years …”

Erythema annulare centrifugum as the presenting sign of breast carcinoma

“…In the literature is reported the possible association between this disease and estrogens; 9 we also described a case of EAC with neonatal onset in a boy with testosterone low serum values, who developed primary genital infantilism with hypogonadism 10 …”