Erythema elevatum diutinum as a first clinical manifestation for diagnosing HIV infection

case history

Authors

  • Patrícia Accioni Rover Hospital Universitário Celso Pierro, Pontifícia Universidade Católica de Campinas
  • Caroline Bittencourt Hospital Universitário Celso Pierro, Pontifícia Universidade Católica de Campinas
  • Mariana Pimenta Discacciati Hospital Universitário Celso Pierro, Pontifícia Universidade Católica de Campinas
  • Mariana Colombini Zaniboni Hospital Universitário Celso Pierro, Pontifícia Universidade Católica de Campinas
  • Lúcia Helena de Fávaro Arruda Hospital Universitário Celso Pierro, Pontifícia Universidade Católica de Campinas
  • Maria Letícia Cintra Hospital Universitário Celso Pierro, Pontifícia Universidade Católica de Campinas

Keywords:

Skin diseases, HIV, Vasculitis, Streptococcal infections, Dapsone

Abstract

CONTEXT: Erythema elevatum diutinum is a chronic and rare dermatosis that is considered to be a variant of leukocytoclastic vasculitis. It is probably mediated by immune complexes. It is generally associated with autoimmune, neoplastic and infectious processes. Recently, it has been added to the group of specific dermatoses that are associated with HIV. CASE REPORT: We report on the case of a patient who had erythema elevatum diutinum as the first clinical evidence for diagnosing HIV infection. Dapsone was used in the treatment of this patient, and partial regression of the lesions was achieved within 15 days, even before anti- retroviral therapy was prescribed. CONCLUSION: When there is a diagnosis of erythema elevatum diutinum, HIV infection should be investigated, especially in atypical and exacerbated clinical manifestations.

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Author Biographies

Patrícia Accioni Rover, Hospital Universitário Celso Pierro, Pontifícia Universidade Católica de Campinas

Medical resident at the Dermatology Clinic, Hospital Universitário Celso Pierro (HMCP), Campinas, São Paulo, Brazil.

Caroline Bittencourt, Hospital Universitário Celso Pierro, Pontifícia Universidade Católica de Campinas

Medical resident at the Dermatology Clinic, Hospital Universitário Celso Pierro (HMCP), Campinas, São Paulo, Brazil.

Mariana Pimenta Discacciati, Hospital Universitário Celso Pierro, Pontifícia Universidade Católica de Campinas

Medical resident at the Internal Medicine Clinic, Hospital Universitário Celso Pierro (HMCP), Campinas, São Paulo, Brazil.

Mariana Colombini Zaniboni, Hospital Universitário Celso Pierro, Pontifícia Universidade Católica de Campinas

MD. Attending doctor at the Dermatology Clinic, Hospital Universitário Celso Pierro (HMCP), Campinas, São Paulo, Brazil.

Lúcia Helena de Fávaro Arruda, Hospital Universitário Celso Pierro, Pontifícia Universidade Católica de Campinas

MD. Head of the Dermatology Clinic, Hospital Universitário Celso Pierro (HMCP), Campinas, São Paulo, Brazil.

Maria Letícia Cintra, Hospital Universitário Celso Pierro, Pontifícia Universidade Católica de Campinas

Pathology Department, Medical School, Pontifícia Universidade Católica de Campinas (PUC-Campinas), Campinas, São Paulo, Brazil.

References

Ramsey ML, Gibson B, Tschen JA, Wolf JE. Erythema elevatum diutinum. Cutis. 1984;34(1):41-3.

Fort SL, Rodman OG. Erythema elevatum diutinum. Response to dapsone. Arch Dermatol. 1977;113(6):819-22.

Yiannias JA, el-Azhary RA, Gibson LE. Erythema elevatum diutinum: a clinical and histopathologic study of 13 patients. J Am Acad Dermatol. 1992;26(1):38-44.

Weidman FD, Besancon JH. Erythema elevatum diutinum. Rôle of streptococci, and relationship to other rheumatic dermatoses. Arch Dermatol Syphilol. 1929;20(5):593-620.

Aractingi S, Bachmeyer C, Dombret H, Vignon-Pennamen D, Degos L, Dubertret L. Simultaneous occurrence of two rare cutaneous mark- ers of poor prognosis in myelodysplastic syndrome: erythema elevatum diutinum and specific lesions. Br J Dermatol. 1994;131(1):112-7.

Kavanagh GM, Colaco CB, Bradfield JW, Archer CB. Erythema elevatum diutinum associated with Wegener’s granulomatosis and IgA paraproteinemia. J Am Acad Dermatol. 1993;28(5 Pt 2):846-9.

Jorizzo JL, Daniels JC. Dermatologic conditions reported in patients with rheumatoid arthritis. J Am Acad Dermatol. 1983;8(4):439-57.

Muratori S, Carrera C, Gorani A, Alessi E. Erythema elevatum diutinum and HIV infection: a report of five cases. Br J Der- matol. 1999;141(2):335-8.

Katz SI, Gallin JI, Hertz KC, Fauci AS, Lawley TJ. Erythema elevatum diutinum: skin and systemic manifestations, immuno- logic studies, and successful treatment with dapsone. Medicine (Baltimore). 1977;56(5):443-55.

Kohler IK, Lorincz AL. Erythema elevatum diutinum treated with niacinamide and tetracycline. Arch Dermatol. 1980;116(6):693-5.

Wilkinson SM, English JS, Smith NP, Wilson-Jones E, Winkel- mann RK. Erythema elevatum diutinum: a clinicopathological study. Clin Exp Dermatol. 1992;17(2):87-93.

Morrison JG, Hull PR, Fourie E. Erythema elevatum diutinum, cryoglobulinaemia, and fixed urticaria on cooling. Br J Derma- tol. 1977;97(1):99-104.

Chow RK, Benny WB, Coupe RL, Dodd WA, Ongley RC. Ery- thema elevatum diutinum associated with IgA paraproteinemia successfully controlled with intermittent plasma exchange. Arch Dermatol. 1996;132(11):1360-4.

Kövary PM, Dhonau H, Happle R. Paraproteinaemia in erythema elevatum diutinum. Arch Dermatol Res. 1977;260(2):155-8.

Archimandritis AJ, Fertakis A, Alegakis G, Bartsokas S, Melis- sinos K. Erythema elevatum diutinum and IgA myeloma: an interesting association. Br Med J. 1977;2(6087):613-4.

Nakajima H, Ikeda M, Yamamoto Y, Kodama H. Erythema elevatum diutinum complicated by rheumatoid arthritis. J Dermatol. 1999;26(7):452-6.

Collier PM, Neill SM, Branfoot AC, Staughton RC. Erythema elevatum diutinum - a solitary lesion in a patient with rheuma- toid arthritis. Clin Exp Dermatol. 1990;15(5):394-5.

Henriksson R, Hofer PA, Hörnqvist R. Erythema elevatum diutinum - a case successfully treated with colchicine. Clin Exp Dermatol. 1989;14(6):451-3.

Tasanen K, Raudasoja R, Kallioinen M, Ranki A. Erythema elevatum diutinum in association with coeliac disease. Br J Dermatol. 1997;136(4):624-7.

Walker KD, Badame AJ. Erythemaelevatumdiutinuminapatientwith Crohn’s disease. J Am Acad Dermatol. 1990;22(5 Pt 2):948-52.

Bernard P, Bedane C, Delrous JL, Catanzano G, Bonnet- blanc JM. Erythema elevatum diutinum in a patient with relapsing polychondritis. J Am Acad Dermatol. 1992;26(2 Pt 2):312-5.

Dronda F, González-Lópes A, Lecona M, Barros C. Erythema elevatum diutinum in human immunodeficiency virus-infected patients - report of a case and review of the literature. Clin Exp Dermatol. 1996;21(3):222-5.

Revenga F, Vera A, Muñoz A, De la Llana FG, Alejo M, Rodrí- guez-Peralto JL. Erythema elevatum diutinum and AIDS: are they related? Clin Exp Dermatol. 1997;22(5):250-1.

Soni BP, Williford PM, Withe WL. Erythematous nodules in a patient infected with the human immunodeficiency virus. Erythema elevatum diutinum (EED). Arch Dermatol. 1998;134(2):232-3, 235-6.

Suárez J, Miguélez M, Villalba R. Nodular erythema elevatum diutinum in an HIV-1 infected woman: response to dapsone and antiretroviral therapy. Br J Dermatol. 1998;138(4):717-8.

Fredenberg MF, Malkinson FD. Sulfone therapy in the treatment of leukocytoclastic vasculitis. Report of three cases. J Am Acad Dermatol. 1987;16(4):772-8.

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Published

2005-07-07

How to Cite

1.
Rover PA, Bittencourt C, Discacciati MP, Zaniboni MC, Arruda LH de F, Cintra ML. Erythema elevatum diutinum as a first clinical manifestation for diagnosing HIV infection: case history. Sao Paulo Med J [Internet]. 2005 Jul. 7 [cited 2025 Mar. 12];123(4):201-3. Available from: https://periodicosapm.emnuvens.com.br/spmj/article/view/2339

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Case Report