At a Glance - Eythema Annulare vs Lymphoma

Contributed by Dr Jean Watkins, a retired GP in Hampshire

ERYTHEMA ANNULARE CENTRIFUGUM


Aetiology

  • Occurs at any age.
  • May be related to: infections; parasites; drugs (antimalarials, penicillin, salicylates, cimetidine, amitriptyline); foods; cholestatic liver disease; or hyperthyroidism.

Clinical features

  • Common on lower limbs but may occur on face, trunk and arms.
  • Small inflammatory spot gradually spreads to form a ring. Central area flattens and clears.
  • Generally no symptoms but may be slightly itchy.

Management

  • Skin scraping to exclude tinea or candida.
  • Treat underlying cause or wait for spontaneous resolution.
  • Topical steroid may reduce inflammation and itching.

PRIMARY CUTANEOUS T-CELL LYMPHOMA

Aetiology

  • Lymphoma of the skin with no evidence of disease elsewhere in the body.
  • May be cutaneous T-cell lymphoma (65 per cent) or cutaneous B-cell lymphoma.
  • Uncommon skin condition. More common in men, rare in children.
  • Cause unknown but possible persistent antigen leading to gene mutations.

Clinical features

  • Patch stage: oval or annular dry, pink patches. Patches may slowly enlarge or disappear spontaneously. May be itchy and have atrophic appearance.
  • Plaque stage: thickened, itchy patches.
  • Tumour stage: plaque thickens into large nodules or tumours. May ulcerate.

Management

  • Skin biopsy to confirm diagnosis.
  • CT or MRI scan in advanced cases to check if other organs involved.
  • Depending on severity, use: topical steroids; phototherapy; topical nitrogen mustard; chemotherapy; radiotherapy; interferons; oral retinoids; or photopheresis.

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Before commenting please read our rules for commenting on articles.

If you see a comment you find offensive, you can flag it as inappropriate. In the top right-hand corner of an individual comment, you will see 'flag as inappropriate'. Clicking this prompts us to review the comment. For further information see our rules for commenting on articles.

comments powered by Disqus