Images in Clinical Medicine
Erythema Gyratum Repens
N Engl J Med 2010; 362:1814May 13, 2010
- Article
An 83-year-old man was evaluated for a 1-year history of a pruritic, progressively worsening migratory rash, with associated weakness and a 5-kg weight loss. He had a 30-pack-year history of smoking; he had stopped smoking 45 years earlier. On examination, he had erythematous skin lesions that appeared in concentric, raised, serpiginous bands, with desquamation (Panel A). The rash affected mainly the trunk and proximal extremities. A clinical diagnosis of erythema gyratum repens was made. A computed tomographic scan revealed a pulmonary mass measuring 59 by 43 mm (Panel B). Bronchoscopy with biopsy revealed squamous-cell carcinoma of the lung. Erythema gyratum repens is a rare syndrome typically associated with an underlying malignant condition. It occurs most frequently in conjunction with lung cancer and next most frequently with esophageal and breast cancers. It may regress with treatment of the cancer. Treatment with gemcitabine was initiated for this patient, but he died 3 months after diagnosis, after only one infusion; the rash had not resolved.
Maia Delage, M.D.
Michael Naouri, M.D.
Université François-Rabelais, Tours, France
maiadelage@hotmail.com
