September 2021 - Case of the Month
A 24-year-old woman presented with a several year history of evolving 'lumps' especially on the central chest. The lady had mild facial acne and was otherwise well.
A 72 year old man was referred with a rash, predominantly on the legs. The patient was systemically well and the lesions were only mildly symptomatic. The lesions presented as one to several at a time lasting several weeks. They had not responded to potent topical steroids. The patient had no other relevant history. Skin swabs and blood tests were unremarkable.
Smooth non-tender erythematous red patches, some of which were annular.
What is the differential and how would you manage this patient?
Unusual rashes not responding to appropriate topical therapies are best referred for diagnosis and further management. If a biopsy is required the pathologist will need to be guided as to what the differential diagnosis is.
Histology showed Eosinophilic annular erythema.
Eosinophilc cellulitis presents with lesions that evolve over a few days to become large, erythematous indurated plaques resembling both cellulitis and urticaria. Eosinophilic annular erythema (EAE) is a rare variant of eosinophilic cellulitis. EAE is clinically characterised by recurrent annular, erythematous-oedematous, pruritic lesions with a centrifugal growth pattern. EAE is most common in children but can affect adults. In a few cases, lesions of both EAE and more typical features of eosinophilic cellulitis have been reported.
Refer to the chapter Eosinophilc cellulitis for more detail.
There are many annular rashes for which the PCDS diagnostic tools can help.
A 24-year-old woman presented with a several year history of evolving 'lumps' especially on the central chest. The lady had mild facial acne and was otherwise well.
A 52 year old man presented with a one year history of skin lesions predominantly on his hands, ears and scalp. He was also complaining of painful swollen fingers associated with morning stiffness. There was no family history of skin or joint problem...
A 72 year old man was referred with a rash, predominantly on the legs. The patient was systemically well and the lesions were only mildly symptomatic. The lesions presented as one to several at a time lasting several weeks. They had not res...
Welcome back to the new look PCDS website, and our first case. This lady was referred as a 2-week wait with a changing lesion on the right temple.
A 15 year old lady was referred for a diagnostic opinion for skin changes presenting in birth, affecting the right upper back, shoulder, antecubital fossa and dorsal wrist. The patient was asymptomatic and otherwise well.
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