Psoriasis erythema anulare centrifugum-like L40.8

Author: Prof. Dr. med. Peter Altmeyer

Co-Autor: Franziska Welke

All authors of this article

Last updated on: 14.03.2022

Dieser Artikel auf Deutsch


Anular pustular psoriasis; Circinar generalized pustular psoriasis; EACP; Erythema annulare centrifugum-like psoriasis cum pustulatione; Erythema anulare centrifugum Degos; Erythema anulare centrifugum-like psoriasis; Erythema circinatum recidivans; pustular psoriasis

This section has been translated automatically.

Milan and Katchoura, 1932

This section has been translated automatically.

Rare, mild special form of pustular psoriasis generalisata (Zumbusch type) with the formation of characteristic garland-shaped (circulatory) skin patterns that are anular and caused by confluence. In EACP, the general symptoms of pustular psoriasis are missing.

This section has been translated automatically.

While EACP is rare in adults, it is the most common pustular psoriasis variant in children.

This section has been translated automatically.

Extremities, gluteal, inguinal and abdominal regions. Face, palmae and plantae always remain free. Localized solitary variants have been described.

Clinical features
This section has been translated automatically.

Chronic, usually relapsing, generalized psoriasis characterized by its prominent anular formations. Depending on the stage of activity, the marginal zones may flake dry or be covered with non-follicular pustules. There is varying intensity of itching. The tendency to heal centrally and a simultaneous peripheral progression leads to the characteristic annular and, when confluent, to garland-like formations. The inward scaling (collerette scaling) of the anular foci is typical. The foci heal with the formation of a coarse lamellar (corneolytic) scaling.

Relapses may be associated with a general feeling of illness, fever and possibly also athralgias.

This section has been translated automatically.

CRP and BSG increased. In the blood count leukocytosis with neutrophilia.

This section has been translated automatically.

Superficial dermatitis with subcorneal pustular formation

This section has been translated automatically.

See below Psoriasis.

Systemic therapeutics of first choice are retinoids in the usual dosages.

Alternatively: ciclosporin A, methotrexate, infliximab, etanercept and adalimumab.

External: glucocorticoids, PUVA therapy.

This section has been translated automatically.

The disease can be triggered by infections, medications (NSAIDs in combination with febrile bacterial infections) or hormonal factors. Erythema anulare-like psoriasis can occur in episodes over years. But also the single occurrence is possible, also complicative in case of a previously known psoriasis vulgaris (e.g. by a longer internal administration of glucocorticoids and their discontinuation = steroid withdrawal).

This section has been translated automatically.

  1. Albert A et al (2007) Erythema annulare centrifugum-like psoriasis cum pustulatione. dermatologist 58:769-773
  2. Casper U et al (1998) Exfoliatio areata linguae et mucosae oris: a mucous membrane manifestation of psoriasis pustulosa? dermatologist 49:850-854
  3. Milan G, Katchoura F(1932) Psoriasis pustuleux generalisé. Bull Soc Fr Dermatol Syph 40: 851-852
  4. Pfohler C et al (2013) Psoriasis vulgaris and psoriasis pustulosa - epidemiology, quality of life, comorbidities and treatment. Curr Rheumatol Rev 9:2-7
  5. Rotstein H (1996) Psoriasis: changing clinical patterns. Australas J Dermatol37 Suppl 1: 27-29
  6. Schaefer W et al. (2015) Erythematous Ülaques with centrifugal spreading, collerette-like scaling and pustules. J Dtsch Dermatol Ges 13:464-467
  7. Soto Lopes MS et al (2013) Paradoxical Reaction to Golimumab: Tumor Necrosis Factor α Inhibitor Inducing Psoriasis Pustulosa. Case Rep Dermatol 7:326-331


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


Last updated on: 14.03.2022