46 - Erythema Annulare Centrifugum and Other Figurate Erythemas Flashcards
Prototype of figurate or reactive erythemas
Erythema annulare centrifugum
Desquamation at the inner margin in EAC
Trailing scale
Y/N: EAC is often asymptomatic.
Yes
Most common symptom associated with EAC
Pruritus
Most frequent sites of involvement in EAC
Buttocks
Thighs
Trunk
Most common cause of EAC
Idiopathic
EAC is linked to
Cutaneous or systemic infections Malignancy Drugs Certain disease states Pregnancy
Paraneoplastic EAC eruptions occur most commonly with
Lymphoproliferative malignancies such as lymphomas and leukemias
In pregant women, EAC tends to occur during
Second and third trimesters
Remits spontaneously around the time of delivery without recurrence
Histological patterns of EAC
Superficial
Deep
EAC is a/an (acute/chronic) condition
Chronic
_____-type lesions of EAC tended to be longer lasting
Deep
Recurrence rate was higher for _____-type EAC
Superficial
Early cutaneous manifestation of Lyme borreliosis
Erythema migrans
Erythema migrans is an infection causes by _____, transmitted through the bite of _____
Borrelia burgdorferi
Species of Ixodes ticks
Natural hosts of Ixodes ticks
White-footed mouse
White-tailed deer
Stages of Lyme disease
Early localized disease
Early disseminated disease
Chronic disease
Erythema migrans is characterized by an erythematous expanding annular plaque with a central area of clearing, often described as a
Bull’s eye lesion
Erythema migrans lesions grow centrifugally and can grow at a rate of up to
3 cm/day
Benign reactive lymphoid hyperplasia that can occur in response to untreated Borrelia infections
Borrelial lymphocytoma
Borrelial lymphocytoma usually observed in the _____ stage
Early disseminated
Enlarging, edematous plaques on the distal extremities with a bluish-red hue that evolve into atrophic plaques
Acrodermatitis chronica atrophicans
Acrodermatitis chronica atrophicans is typical of
Chronic Lyme disease infection
Borrelia burgdorferi survive in a protected environment in the tick _____ epithelium
Midgut
2-step process to support the diagnosis of Lyme disease
- Enzyme immunoassay or indirect immunofluorescence assay
2. Western blot analysis
Western blot analysis in Lyme disease should not be performed without a positive or equivocal antibody test becase of the risk for _____ results
False-positive
Stain that can be used to detect B. burgdorferi in the skin
Warthin-Starry stain
Most common antibiotics used to treat Lyme disease
Doxycycline
Amoxicillin
Cefuroxime
Lyme disease prophylaxis
Single dose of doxycycline
Empiric antibiotic treatment of individuals with tick bites is not recommended, as only _____% of individuals bitten by ticks in endemic areas develop Lyme disease
1
Major criteria for acute rheumatic fever
Carditis Migratory polyarthritis Syndenham chorea Erythema marginatum Subcutaneous nodules
Minor criteria for acute rheumatic fever
Fever
Arthralgias
Abnormal laboratory findings such as elevated ESR, CSR
Prolonged PR interval on ECG
The diagnosis of acute rheumatic fever is made when _____ criteria are met
2 major or
1 major and 2 minor
Erythema marginatum occurs more often in
Children
Erythema marginatum has a predilection for the _____, and typically spare the _____
Trunk, axillae, proximal extremities
Face
Erythema marginatum tends to appear and disappear and may be more evident with
Hot showers or baths
Subcutaneous nodules of ARF typically occur where
Over bony prominences
Subcutaneous nodules of ARF are seeing more in
Patients with chronic, longstanding disease
Y/N: Subcutaneous nodules of ARF are painful.
No - usually painless
Erythema marginatum often occurs in conjunction with
Acute carditis
Most severe complication of ARC
Rheumatic heart disease with valvular damage (most often involving calcification of the mitral valve)
Chronic, painless arthropathy of the hands and feet which is a complication of ARF
Jaccoud arthropathy
Y/N: After the treatment of acute rheumatic fever, lesions of erythema marginatum resolve.
No - lesions of erythema marginatum may persist
Treatment for erythema marginatum
No intervention necessary; self-limited and eventually resolve spontaneously
Approximately _____% of erythema gyratum repens are associated with malignancy
70-80
Most common neoplasms associated with erythema gyratum repens
Lung
Breast
Esophagus
Stomach
Multiple, erythematous, annular lesions that form concentric rings imparting a “wood-grain” pattern
Erythema gyratum repens
