J Cutan Pathol 2019 Feb 3;46(2):97-101. Epub 2018 Dec 3.
Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio.
Background: Erythema elevatum diutinum (EED) is a rare vasculitis with variable clinical presentation which diagnosis can be challenging. Herein we want to describe the clinicopathological spectrum of findings in five cases of EED.
Methods: We retrospectively analyzed five cases in a single institution collected over a period of 27 years. The clinical history was collected and all the slides were examined to determine the histopathological characteristics of the lesions.
Results: The mean age of our patients is 56.6 years. Two of five patients were females and with lesions showing predilection for the upper-extremities. The most common presentation was of an erythematous plaque on the extensor surfaces. Three patients had a history of neoplasm. All cases showed leukocytoclastic damage consistent with EED.
Conclusion: Our findings suggest that EED shows a heterogeneous clinical and pathological presentation, which can show an overlap with granulomatous dermatoses and mixed connective tissue diseases. Scalp lesions can occur and can mimic granulomatous dermatoses. The finding of EED in benign and malignant solid tumors in three of our patients begs the question whether there is an association between EED and such solid neoplasms.