Английская Википедия:Erythema gyratum repens
Шаблон:Infobox medical condition (new) 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.[2] 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.[3]
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.[2]
Diagnosis is generally by its appearance, although tests may be required to exclude other conditions.[2] 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.[3][5] The rash typically resolves with successful cancer treatment.[2]
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.[2] 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.[3] 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.[2] 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.[3] Less frequently, the cause may be tuberculosis of the lung, or no cause is found.[2] Other rare reported associations have included cryptogenic organizing pneumonia and rheumatoid arthritis.[3]
Diagnosis
Diagnosis is generally by its appearance.[2] Tests include blood tests such as a complete blood count which may reveal raised eosinophils.[3] 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.[3][5] The rash typically resolves with successful cancer treatment.[2]
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
External links
Шаблон:Medical resources Шаблон:Urticaria and erythema Шаблон:Paraneoplastic syndromes
- ↑ 1,00 1,01 1,02 1,03 1,04 1,05 1,06 1,07 1,08 1,09 1,10 1,11 1,12 1,13 1,14 1,15 1,16 1,17 1,18 1,19 1,20 1,21 1,22 Шаблон:Cite book
- ↑ 2,0 2,1 2,2 2,3 2,4 2,5 2,6 2,7 2,8 Шаблон:Cite book
- ↑ 3,0 3,1 3,2 3,3 3,4 3,5 3,6 Шаблон:Cite book
- ↑ 4,0 4,1 Шаблон:Cite book
- ↑ 5,0 5,1 5,2 Шаблон:Cite web
- ↑ 6,0 6,1 Шаблон:Cite journal
- ↑ 7,0 7,1 Шаблон:Cite journal
