Erythema anulare rheumaticum L53.2; I00+L54.0;

Author: Prof. Dr. med. Peter Altmeyer

Our authors

Last updated on: 29.10.2020

Dieser Artikel auf Deutsch

Synonym(s)

Erythema annulare marginatum; Erythema annulare rheumaticum; Erythema circinatum; Erythema marginatum rheumaticum; erythema rheumaticum

History
This section has been translated automatically.

Bright 1831; Chealde 1889; Leiner and Lehndorff 1922;

Definition
This section has been translated automatically.

Specific immunological response to toxins from beta-hemolytic Group A Streptococci. The starting point is a streptococcal angina or pharyngitis.

The erythema anulare rheumaticum is one of the 5 main criteria of rheumatic feverdefined by the "American Heart Association", which occurs in 10% of patients.

Occurrence/Epidemiology
This section has been translated automatically.

The disease can occur worldwide, but is becoming increasingly rare in industrialized countries. It mainly affects children.

Etiopathogenesis
This section has been translated automatically.

The cause of rheumatic fever is angina tonsillaris or streptococcal pharyngitis caused by beta-hemolytic Lancefield Group A streptococci. Rheumatic fever is the result of an infection-induced autoimmune reaction to the local streptococcal infection.

Localization
This section has been translated automatically.

Mainly upper abdominal area (especially periumbilical) and back. Also buttocks and back of the hands, more rarely the face can be affected.

Clinical features
This section has been translated automatically.

Manifestation on the joints (polyarthritis), heart (endo-myo-pericarditis), on the skin in the form of reddish-brownish, non-itching, anular or polycyclic erythema and so-called rheumatic nodules, and on the CNS as minor chorea.

The exanthema is usually accompanied by fever attacks and is more pronounced in the late afternoon. The characteristic skin changes often occur at the beginning of the acute rheumatic fever, often as accompanying symptoms to the joint and heart involvement.

Acute rheumatic fever may also be accompanied by non-figured exanthema, small red urticarial spots, papules or plaques on the knees and elbows, which recede within days or a few weeks without forming any abnormal formations (Erythema papulatum: Cockayne 1912)

Histology
This section has been translated automatically.

Superficial, perivascular and interstitial dermatitis; unspecific pattern; round cell infiltrates.

Differential diagnosis
This section has been translated automatically.

Therapy
This section has been translated automatically.

Paediatric treatment of rheumatic fever.

Progression/forecast
This section has been translated automatically.

The individual changes fade away after a few days. The exanthema attacks subside after weeks to months.

Note(s)
This section has been translated automatically.

If the peripheral areas of the anular erythema are palpable, this form is also called erythema marginatum rheumaticum (erythema annulare marginatum).

Literature
This section has been translated automatically.

  1. Barlow T (1883) Erythema marginatum. Br Med J 509
  2. Chockalingam A et al (2004) Rheumatic heart disease occurrence, patterns and clinical correlates in children aged less than five years. J Heart Valve Dis 13: 11-14
  3. Lehndorff H, Leiner C (1922) Erythema annulare. Z Kinderheilkd (Berlin) 32: 46
  4. Rullan E et al (2001) Rheumatic fever. Curr Rheumatol Rep 3: 445-452

Disclaimer

Please ask your physician for a reliable diagnosis. This website is only meant as a reference.

Authors

Last updated on: 29.10.2020