ERYTHEMA-ELEVATUM-DIUTINUM - A CLINICOPATHOLOGICAL STUDY OF 8 CASES

Erythema elevatum diutinum (EED) is a rare cutaneous condition that in itially presents as leukocytoclastic vasculitis (LCCV) of the skin and later resolves with fibrosis. In addition to the LCCV, EED may show f eatures reminiscent of other entities. For example, it may mimic lesio ns of dermatofibroma. granuloma annulare, granuloma faciale. or dermat itis herpetiformis. For this study, we reviewed the clinical records a nd 13 skin biopsies in eight patients with EED. One of the patients ha d concurrent pityriasis rubra pilaris, and another developed lesions o f EED following and at the sites of mosquito bites; these associations have not been noted previously. In addition to such typical histopath ological features as diffuse dermal involvement by neutrophils, eosino phils, and leukocytoclastic vasculitis. we also found two unusual patt erns. The first was characterized by palisaded necrotizing granulomas, as previously described and associated with Churg-Strauss granuloma; the second condition simulated a pyogenicgranuloma-like lesion.