46 - Erythema Annulare Centrifugum and Other Figurate Erythemas

Question 1

Prototype of figurate or reactive erythemas

Answer 1

Erythema annulare centrifugum

Question 2

Desquamation at the inner margin in EAC

Answer 2

Trailing scale

Question 3

Y/N: EAC is often asymptomatic.

Answer 3

Yes

Question 4

Most common symptom associated with EAC

Answer 4

Pruritus

Question 5

Most frequent sites of involvement in EAC

Answer 5

Buttocks
Thighs
Trunk

Question 6

Most common cause of EAC

Answer 6

Idiopathic

Question 7

EAC is linked to

Answer 7

Cutaneous or systemic infections
Malignancy
Drugs
Certain disease states
Pregnancy

Question 8

Paraneoplastic EAC eruptions occur most commonly with

Answer 8

Lymphoproliferative malignancies such as lymphomas and leukemias

Question 9

In pregant women, EAC tends to occur during

Answer 9

Second and third trimesters

Remits spontaneously around the time of delivery without recurrence

Question 10

Histological patterns of EAC

Answer 10

Superficial

Deep

Question 11

EAC is a/an (acute/chronic) condition

Answer 11

Chronic

Question 12

_____-type lesions of EAC tended to be longer lasting

Answer 12

Deep

Question 13

Recurrence rate was higher for _____-type EAC

Answer 13

Superficial

Question 14

Early cutaneous manifestation of Lyme borreliosis

Answer 14

Erythema migrans

Question 15

Erythema migrans is an infection causes by _____, transmitted through the bite of _____

Answer 15

Borrelia burgdorferi

Species of Ixodes ticks

Question 16

Natural hosts of Ixodes ticks

Answer 16

White-footed mouse

White-tailed deer

Question 17

Stages of Lyme disease

Answer 17

Early localized disease
Early disseminated disease
Chronic disease

Question 18

Erythema migrans is characterized by an erythematous expanding annular plaque with a central area of clearing, often described as a

Answer 18

Bull’s eye lesion

Question 19

Erythema migrans lesions grow centrifugally and can grow at a rate of up to

Answer 19

3 cm/day

Question 20

Benign reactive lymphoid hyperplasia that can occur in response to untreated Borrelia infections

Answer 20

Borrelial lymphocytoma

Question 21

Borrelial lymphocytoma usually observed in the _____ stage

Answer 21

Early disseminated

Question 22

Enlarging, edematous plaques on the distal extremities with a bluish-red hue that evolve into atrophic plaques

Answer 22

Acrodermatitis chronica atrophicans

Question 23

Acrodermatitis chronica atrophicans is typical of

Answer 23

Chronic Lyme disease infection

Question 24

Borrelia burgdorferi survive in a protected environment in the tick _____ epithelium

Answer 24

Midgut

Question 25

2-step process to support the diagnosis of Lyme disease

Answer 25

1. Enzyme immunoassay or indirect immunofluorescence assay | 2. Western blot analysis

Question 26

Western blot analysis in Lyme disease should not be performed without a positive or equivocal antibody test becase of the risk for _____ results

Answer 26

False-positive

Question 27

Stain that can be used to detect B. burgdorferi in the skin

Answer 27

Warthin-Starry stain

Question 28

Most common antibiotics used to treat Lyme disease

Answer 28

Doxycycline Amoxicillin Cefuroxime

Question 29

Lyme disease prophylaxis

Answer 29

Single dose of doxycycline

Question 30

Empiric antibiotic treatment of individuals with tick bites is not recommended, as only _____% of individuals bitten by ticks in endemic areas develop Lyme disease

Answer 30

1

Question 31

Major criteria for acute rheumatic fever

Answer 31

``` Carditis Migratory polyarthritis Syndenham chorea Erythema marginatum Subcutaneous nodules ```

Question 32

Minor criteria for acute rheumatic fever

Answer 32

Fever Arthralgias Abnormal laboratory findings such as elevated ESR, CSR Prolonged PR interval on ECG

Question 33

The diagnosis of acute rheumatic fever is made when _____ criteria are met

Answer 33

2 major or | 1 major and 2 minor

Question 34

Erythema marginatum occurs more often in

Answer 34

Children

Question 35

Erythema marginatum has a predilection for the _____, and typically spare the _____

Answer 35

Trunk, axillae, proximal extremities | Face

Question 36

Erythema marginatum tends to appear and disappear and may be more evident with

Answer 36

Hot showers or baths

Question 37

Subcutaneous nodules of ARF typically occur where

Answer 37

Over bony prominences

Question 38

Subcutaneous nodules of ARF are seeing more in

Answer 38

Patients with chronic, longstanding disease

Question 39

Y/N: Subcutaneous nodules of ARF are painful.

Answer 39

No - usually painless

Question 40

Erythema marginatum often occurs in conjunction with

Answer 40

Acute carditis

Question 41

Most severe complication of ARC

Answer 41

Rheumatic heart disease with valvular damage (most often involving calcification of the mitral valve)

Question 42

Chronic, painless arthropathy of the hands and feet which is a complication of ARF

Answer 42

Jaccoud arthropathy

Question 43

Y/N: After the treatment of acute rheumatic fever, lesions of erythema marginatum resolve.

Answer 43

No - lesions of erythema marginatum may persist

Question 44

Treatment for erythema marginatum

Answer 44

No intervention necessary; self-limited and eventually resolve spontaneously

Question 45

Approximately _____% of erythema gyratum repens are associated with malignancy

Answer 45

70-80

Question 46

Most common neoplasms associated with erythema gyratum repens

Answer 46

Lung Breast Esophagus Stomach

Question 47

Multiple, erythematous, annular lesions that form concentric rings imparting a “wood-grain” pattern

Answer 47

Erythema gyratum repens