Recurrent Erythema Annulare Centrifugum due to Influenza Type A

Abstract

Erythema annulare centrifugum (EAC) is a rare erythema characterized by erythematous and urticarial papules or annular plaques that enlarges centrifugally. The lesions usually involve the thighs and the legs. Several disorders are occasionally associated with EAC, infections, including mycoses, bacteria, or viruses and drugs have also been regarded as possible causes of this eruption. We present a 42-year-old dark-skinned woman affected by recurrent EAC that appeared secondary to influenza type A (H1N1). Histopathology showed a superficial form of EAC. In our case, a previous cytomegalovirus and Epstein-Barr virus (EBV) infection were identified and no underlying other diseases were found. Clarithromycin with calcipotriol betamethasone treatment was temporarily efficacious. In the last 3 years, the lesions started to appear every 2 weeks and tended to regress with local treatment after a variable period. We believe that the latent cytomegalovirus and the reactivity induced by EBV combined with influenza can determine, in our case, a cell mediate cutaneous immune response, which leads to the peculiar inflammatory disease known as EAC.

Eritema anular centrífugo como marcador cutáneo de comorbilidades

“…En cuanto a las primeras, encontramos tres relacionadas con molusco contagioso, tres con herpes zóster, uno con influenza H1N1, uno seropositivo para VIH, uno con Epstein-Barr y un último caso asociado con SARS-CoV-2. [30][31][32][33][34][35][36][37][38] Los casos reportados asociados con infecciones bacterianas fueron dos con tuberculosis pulmonar, dos con faringoamigdalitis estreptocócica, uno con infección de vías urinarias por E. coli, un caso de sepsis por Pseudomona aeruginosa, uno con monoartritis por Capnocytophaga canimorsus y un paciente con sífilis. [39][40][41][42][43][44][45][46] En cuanto a las parasitosis, únicamente se encontraron dos: uno por Pthirus pubis y otro por Ascaris.…”

Azole Antifungal–Induced Erythema Annulare Centrifugum in a Case of Extensive Tinea

“…Probable hypotheses include IFN-γ release by lymphocytes, cytokine storm resulting from activation of cytotoxic T cells, and cross-reactivity of autologous immune cells to keratinocyte surface antigens. [ 6 ] The azole antifungals include two broad classes: imidazoles and triazoles. Though cross-reactivity within members of antifungal triazoles and imidazoles has been observed in literature, no consistent pattern of cross-reactivity has been described, and it remains poorly understood.…”