Diagnostic and therapeutic challenges in erythema elevatum diutinum

Justyna Milewska; Paulina Chmielińska; Joanna Czuwara; Alicja Kryst; Magdalena Jasińska; Adriana Rakowska; Małgorzata Olszewska; Lidia Rudnicka

doi:10.5114/dr.2023.138880

eISSN: 2084-9893
ISSN: 0033-2526

Dermatology Review/Przegląd Dermatologiczny

Current issue Archive Manuscripts accepted About the journal Special Issues Editorial board Abstracting and indexing Subscription Contact Instructions for authors Ethical standards and procedures

Editorial System

Submit your Manuscript

Editorial Policies

Sarajevo Declaration on Integrity and Visibility of Scholarly Publications

Open access

6/2023
vol. 110

Send email

Copy url:

abstract:

Case report

Diagnostic and therapeutic challenges in erythema elevatum diutinum

Justyna Milewska

¹

,

Paulina Chmielińska

¹

,

Joanna Czuwara

¹

,

Alicja Kryst

¹

,

Magdalena Jasińska

¹

,

Adriana Rakowska

¹

,

Małgorzata Olszewska

¹

,

Lidia Rudnicka

¹

Department of Dermatology, Medical University of Warsaw, Warsaw, Poland

Dermatol Rev/Przegl Dermatol 2023, 110, 711-715

DOI: https://doi.org/10.5114/dr.2023.138880

Online publish date: 2024/05/03

View full text Get citation

PlumX metrics:

Introduction:
Erythema elevatum diutinum (EED) is a rare form of cutaneous fibrosing type of leukocytoclastic vasculitis leading sometimes to nodule formation, imitating neoplastic process.

Case report:
We present the case of a 65-year-old woman with a 6-year history of cutaneous presentation of erythema elevatum diutinum, coexisting with myasthenia gravis and monoclonal IgA gammopathy. Dermoscopy of the skin lesions showed prominent thick arborizing vessels in a concentric alignment. Previous treatment with the use of methotrexate, dapsone, mycophenolate mofetil and cyclosporine did not stop the disease progression. Laboratory tests showed the presence of monoclonal protein IgAk in the serum and X-ray examination showed numerous fine-spot thinning of bone structure, especially within the skull bones. Hematological treatment with thalidomide and cyclophosphamide was introduced. A rapid resolution of skin lesions was observed.

Conclusions:
This case shows that management of the underlying hematological abnormality may be essential for successful therapy of the otherwise treatment resistant erythema elevatum diutinum.

keywords:

Diagnostic and therapeutic challenges in erythema elevatum diutinum

Justyna Milewska 1 , Paulina Chmielińska 1 , Joanna Czuwara 1 , Alicja Kryst 1 , Magdalena Jasińska 1 , Adriana Rakowska 1 , Małgorzata Olszewska 1 , Lidia Rudnicka 1

erythema elevatum diutinum, IgA monoclonal gammopathy, myasthenia gravis

Justyna Milewska

¹

,

Paulina Chmielińska

¹

,

Joanna Czuwara

¹

,

Alicja Kryst

¹

,

Magdalena Jasińska

¹

,

Adriana Rakowska

¹

,

Małgorzata Olszewska

¹

,

Lidia Rudnicka

¹