| Erythema gyratum repens | |
|---|---|
| Specialty |
Dermatology
 |
| Symptoms | Expanding swirly wavy red lines, scale, itch [1] |
| Usual onset | Older adults (60s) [1] |
| Causes | Cancer: lung cancer, oesophageal cancer, breast cancer [1] |
| Diagnostic method |
|
| Differential diagnosis | Necrolytic migratory erythema, erythema migrans, erythrokeratodermia variabilis, subacute cutaneous lupus erythematosus, tinea corporis [1] |
| Treatment | Treat underlying cause [1] |
| Medication | Antihistamines [2] |
| Prognosis | Resolves with successful cancer treatment [1] |
| Frequency | Rare, male:females (2:1) [1] |
Erythema gyratum repens is a skin condition that has a strong association with internal cancers. [1] It characteristically presents with red wavy lines, generally in older adults. [1] These regular whirly rings rapidly and repetitively appear within existing ones, giving the impression that the rash is moving. [3] The resulting pattern is similar to wood grain. [1] There is often an intense itch and scale over the leading edge, which may be slightly raised. [2]
The cause is believed to have an immunological base. [4] 80% of cases have an underlying cancer, of which almost half have lung cancer. [1] Sometimes no cause is found. [3]
Diagnosis is generally by its appearance, although tests may be required to exclude other conditions. [3] These tests may include blood tests. [1] A cancer may be located using medical imaging. [1] Necrolytic migratory erythema and erythema migrans are some of many other skin conditions that may appear similar. [1]
Treatment and outlook depend on the underlying cause. [1] Antihistamines may help to reduce the itch. [2] [5] The rash typically resolves with successful cancer treatment. [3]
The condition is rare. [1] Males are affected twice as frequently as females. [1] J. A. Gammel first described the condition in 1952. [6] [7]
Signs and symptoms
Erythema gyratum repens characteristically presents as wavy red lines on the skin. [1] These regular whirly rings rapidly and repetitively appear within existing ones, expanding outward at a rate of up to 1cm a day, giving the impression that the rash is moving. [3] The resulting pattern is similar to wood grain. [1] There is typically an intense itch and scale over the leading edge, which may be slightly raised. [2] The trunk and limbs are most frequently affected. [5] Thickening of the skin of the palms co-exists in around 10% of affected individuals, whatever the underlying cause. [1] The skin may become extremely dry. [3] Onset is generally in older adults; after the age of 60-years. [1]
Cause
The cause is believed to have an immunological base. [4] 80% of cases have an underlying cancer, of which almost half have lung cancer. [1] Other cancers reported to be associated include cancers of the oesophagus and breast, and less frequently gastric cancer, uterine cancer, throat cancer, pancreas cancer and lymphoma. [1] The rash generally precedes the cancer diagnosis by around 9-months. [2] Less frequently, the cause may be tuberculosis of the lung, or no cause is found. [3] Other rare reported associations have included cryptogenic organizing pneumonia and rheumatoid arthritis. [2]
Diagnosis
Diagnosis is generally by its appearance. [3] Tests include blood tests such as a complete blood count which may reveal raised eosinophils. [2] Other blood tests include PSA, antinuclear antibodies and biochemistry. [1] Medical imaging may locate a cancer; chest X-ray, mammogram, CT scan of pelvis and abdomen. [1] If indicated then an endoscopy may be required; colonoscopy, gastroscopy. [1]
Differential diagnosis
Necrolytic migratory erythema, erythema migrans, tinea corporis, erythrokeratodermia variabilis, and subacute cutaneous lupus erythematosus are some of many other skin conditions that may appear similar. [1]
Treatment
Treatment and outlook depend on the underlying cause. [1] Antihistamines may help to reduce the itch, although the role of applying a steroid cream is unclear. [2] [5] The rash typically resolves with successful cancer treatment. [3]
Epidemiology
The condition is rare. [1] Males are affected twice as frequently as females. [1]
History
J. A. Gammel first described the condition in 1952, in an individual who was later found to have breast cancer. [6] [7]
See also
- List of cutaneous conditions associated with internal malignancy
- List of migrating cutaneous conditions
References
- ^ a b c d e f g h i j k l m n o p q r s t u v w x y z aa ab ac ad ae af ag Griffiths, Christopher E. M.; Bleiker, Tanya O.; Creamer, Daniel; Ingram, John R.; Simpson, Rosalind C. (2022). "19. Reactive inflammatory erythemas". Rook's Dermatology Handbook. Hoboken: Wiley-Blackwell. p. 259. ISBN 978-1-119-42819-0.
- ^ a b c d e f g h James, William D.; Elston, Dirk; Treat, James R.; Rosenbach, Misha A.; Neuhaus, Isaac (2020). "7. Erythema and urticaria". Andrews' Diseases of the Skin: Clinical Dermatology (13th ed.). Edinburgh: Elsevier. p. 144. ISBN 978-0-323-54753-6.
- ^ a b c d e f g h i Bolognia, Jean L.; Schaffer, Julie V.; Duncan, Karynne O.; Ko, Christine (2021). "15. Figurate erythemas". Dermatology Essentials (2nd ed.). Elsevier. pp. 142–148. ISBN 978-0-323-70971-2.
- ^ a b Motta, Adriana; González, Luis Fernando; García, Gonzalo; Guzmán, Jennifer; Prada, Lorena; Herrera, Hugo; Rolon, Mariam (2022). "11. Inflammatory skin diseases presenting with erythema, urticaria and purpura". Atlas of Dermatology: Inflammatory, Infectious and Tumoral Skin Diseases. Springer. pp. 310–311. ISBN 978-3-030-84106-5.
- ^ a b c "Erythema gyratum repens | DermNet". dermnetnz.org.
- ^ a b Boehner, Alexander; Neuhauser, Ruth; Zink, Alexander; Ring, Johannes (July 2021). "Figurate erythemas - update and diagnostic approach". Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology. 19 (7): 963–972. doi: 10.1111/ddg.14450. ISSN 1610-0387. PMID 34046996.
- ^ a b Gammel, J. A. (October 1952). "Erythema gyratum repens; skin manifestations in patient with carcinoma of breast". A.M.A. Archives of Dermatology and Syphilology. 66 (4): 494–505. doi: 10.1001/archderm.1952.01530290070010. ISSN 0096-5979. PMID 12975861.
External links
| Erythema gyratum repens | |
|---|---|
| Specialty |
Dermatology
|
| Symptoms | Expanding swirly wavy red lines, scale, itch [1] |
| Usual onset | Older adults (60s) [1] |
| Causes | Cancer: lung cancer, oesophageal cancer, breast cancer [1] |
| Diagnostic method |
|
| Differential diagnosis | Necrolytic migratory erythema, erythema migrans, erythrokeratodermia variabilis, subacute cutaneous lupus erythematosus, tinea corporis [1] |
| Treatment | Treat underlying cause [1] |
| Medication | Antihistamines [2] |
| Prognosis | Resolves with successful cancer treatment [1] |
| Frequency | Rare, male:females (2:1) [1] |
Erythema gyratum repens is a skin condition that has a strong association with internal cancers. [1] It characteristically presents with red wavy lines, generally in older adults. [1] These regular whirly rings rapidly and repetitively appear within existing ones, giving the impression that the rash is moving. [3] The resulting pattern is similar to wood grain. [1] There is often an intense itch and scale over the leading edge, which may be slightly raised. [2]
The cause is believed to have an immunological base. [4] 80% of cases have an underlying cancer, of which almost half have lung cancer. [1] Sometimes no cause is found. [3]
Diagnosis is generally by its appearance, although tests may be required to exclude other conditions. [3] These tests may include blood tests. [1] A cancer may be located using medical imaging. [1] Necrolytic migratory erythema and erythema migrans are some of many other skin conditions that may appear similar. [1]
Treatment and outlook depend on the underlying cause. [1] Antihistamines may help to reduce the itch. [2] [5] The rash typically resolves with successful cancer treatment. [3]
The condition is rare. [1] Males are affected twice as frequently as females. [1] J. A. Gammel first described the condition in 1952. [6] [7]
Signs and symptoms
Erythema gyratum repens characteristically presents as wavy red lines on the skin. [1] These regular whirly rings rapidly and repetitively appear within existing ones, expanding outward at a rate of up to 1cm a day, giving the impression that the rash is moving. [3] The resulting pattern is similar to wood grain. [1] There is typically an intense itch and scale over the leading edge, which may be slightly raised. [2] The trunk and limbs are most frequently affected. [5] Thickening of the skin of the palms co-exists in around 10% of affected individuals, whatever the underlying cause. [1] The skin may become extremely dry. [3] Onset is generally in older adults; after the age of 60-years. [1]
Cause
The cause is believed to have an immunological base. [4] 80% of cases have an underlying cancer, of which almost half have lung cancer. [1] Other cancers reported to be associated include cancers of the oesophagus and breast, and less frequently gastric cancer, uterine cancer, throat cancer, pancreas cancer and lymphoma. [1] The rash generally precedes the cancer diagnosis by around 9-months. [2] Less frequently, the cause may be tuberculosis of the lung, or no cause is found. [3] Other rare reported associations have included cryptogenic organizing pneumonia and rheumatoid arthritis. [2]
Diagnosis
Diagnosis is generally by its appearance. [3] Tests include blood tests such as a complete blood count which may reveal raised eosinophils. [2] Other blood tests include PSA, antinuclear antibodies and biochemistry. [1] Medical imaging may locate a cancer; chest X-ray, mammogram, CT scan of pelvis and abdomen. [1] If indicated then an endoscopy may be required; colonoscopy, gastroscopy. [1]
Differential diagnosis
Necrolytic migratory erythema, erythema migrans, tinea corporis, erythrokeratodermia variabilis, and subacute cutaneous lupus erythematosus are some of many other skin conditions that may appear similar. [1]
Treatment
Treatment and outlook depend on the underlying cause. [1] Antihistamines may help to reduce the itch, although the role of applying a steroid cream is unclear. [2] [5] The rash typically resolves with successful cancer treatment. [3]
Epidemiology
The condition is rare. [1] Males are affected twice as frequently as females. [1]
History
J. A. Gammel first described the condition in 1952, in an individual who was later found to have breast cancer. [6] [7]
See also
- List of cutaneous conditions associated with internal malignancy
- List of migrating cutaneous conditions
References
- ^ a b c d e f g h i j k l m n o p q r s t u v w x y z aa ab ac ad ae af ag Griffiths, Christopher E. M.; Bleiker, Tanya O.; Creamer, Daniel; Ingram, John R.; Simpson, Rosalind C. (2022). "19. Reactive inflammatory erythemas". Rook's Dermatology Handbook. Hoboken: Wiley-Blackwell. p. 259. ISBN 978-1-119-42819-0.
- ^ a b c d e f g h James, William D.; Elston, Dirk; Treat, James R.; Rosenbach, Misha A.; Neuhaus, Isaac (2020). "7. Erythema and urticaria". Andrews' Diseases of the Skin: Clinical Dermatology (13th ed.). Edinburgh: Elsevier. p. 144. ISBN 978-0-323-54753-6.
- ^ a b c d e f g h i Bolognia, Jean L.; Schaffer, Julie V.; Duncan, Karynne O.; Ko, Christine (2021). "15. Figurate erythemas". Dermatology Essentials (2nd ed.). Elsevier. pp. 142–148. ISBN 978-0-323-70971-2.
- ^ a b Motta, Adriana; González, Luis Fernando; García, Gonzalo; Guzmán, Jennifer; Prada, Lorena; Herrera, Hugo; Rolon, Mariam (2022). "11. Inflammatory skin diseases presenting with erythema, urticaria and purpura". Atlas of Dermatology: Inflammatory, Infectious and Tumoral Skin Diseases. Springer. pp. 310–311. ISBN 978-3-030-84106-5.
- ^ a b c "Erythema gyratum repens | DermNet". dermnetnz.org.
- ^ a b Boehner, Alexander; Neuhauser, Ruth; Zink, Alexander; Ring, Johannes (July 2021). "Figurate erythemas - update and diagnostic approach". Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology. 19 (7): 963–972. doi: 10.1111/ddg.14450. ISSN 1610-0387. PMID 34046996.
- ^ a b Gammel, J. A. (October 1952). "Erythema gyratum repens; skin manifestations in patient with carcinoma of breast". A.M.A. Archives of Dermatology and Syphilology. 66 (4): 494–505. doi: 10.1001/archderm.1952.01530290070010. ISSN 0096-5979. PMID 12975861.