PALPABLE MIGRATORY ARCIFORM ERYTHEMA - CLINICAL MORPHOLOGY, HISTOPATHOLOGY, IMMUNOHISTOCHEMISTRY, AND RESPONSE TO TREATMENT

Background: Palpable migratory arciform erythema is clinically charact erized by sharply circumscribed, infiltrated erythematous patches that tend to spread irregularly, resulting in arciform morphologic feature s. The histopathologic features are characterized by a patchy inflamma tory perivascular and periadnexal T-lymphocytic infiltrate throughout the dermis. The disease runs a chronic course and is rarely described in the literature. Observation: Three middle-aged patients of both sex es had palpable migratory arciform erythema with 1, several, or multip le lesions on the trunk. There was a dense perivascular and periadnexa l, predominantly lymphocytic infiltrate of the reticular dermis withou t any interstitial distribution of inflammatory cells. Absence of muci n deposits and plasma cells was a striking feature. The immunohistoche mical profile showed an infiltrate dominated by T cells of polyclonal origin. In addition, polyclonal B cells and histiocytes were present i n small, numbers. In all 3 cases, oral antibacterial treatment resulte d in a complete (2 patients) or temporary (1 patient) resolution of sk in lesions. Conclusions: Palpable migratory arciform erythema shows di stinctive differences in clinical and pathological features and treatm ent in contrast to other diseases with cutaneous lymphocytic infiltrat es, including lymphocytic infiltration of Jessner and Kanof. Therefore , it is likely a distinct disease entity.