In this report we present the case of a 61-year-old gentleman with stage IV squamous cell carcinoma of the esophagus who presented with EGR two months after the diagnosis of his malignancy. [cureus.com]

The presentation of the skin disorder was so distinctive that a differential diagnosis was difficult to generate. [ijdvl.com]

One rare presentation of CTCL is an EGR-like eruption. [mdedge.com]

We report a 76-year-old male patient who initially presented with non-characteristic erythematous papules. [symbiosisonlinepublishing.com]

Case Presentation A 71-year-old white female with a past medical history of chronic obstructive pulmonary disease secondary to long-term tobacco use presented with a 3-month history of a rash in her right axilla. [karger.com]

• Anemia

  119 (2017). https://doi.org/10.1007/s10354-016-0513-7 Download citation Received: 03 July 2016 Accepted: 04 August 2016 Published: 23 September 2016 Issue Date: April 2017 DOI: https://doi.org/10.1007/s10354-016-0513-7 Keywords Goiter Iron Deficiency Anemia [link.springer.com]

  On complete blood count, the patient had microcytic hypochromic iron deficiency anemia with hemoglobin of 9.9 g/dL, serum iron level 4.0 μmol/L; (normal range: 11.6-31.2 μmol/L). Bone marrow aspirate did not reveal any abnormalities. [ijdvl.com]

  […] sloughing Crusted Erythematous scaly plaques with centrifugal growth Red erythematous scaly plaques over Perineum, distal extremities, lower abdomen, and face Spontaneous exacerbation and remission periods without knowing what the trigger is Weight loss Anemia [wikidoc.org]

• Asymptomatic

  We report the case of a 71-year-old female patient clinically diagnosed with EGR and subsequently diagnosed with otherwise asymptomatic adenocarcinoma of the lung. © 2019 The Author(s). Published by S. [karger.com]

  One year later, he developed an asymptomatic rash all over the body. There was no history of intake of immunosuppressive drugs. There were no associated breathlessness, cough, or loss of weight. [e-ijd.org]

• Malaise

  New skin lesions continued to develop on an intermittent basis, were painful and accompanied by fever, malaise and deterioration of respiratory function. The patient was admitted for investigations and management. [ijdvl.com]

  Weight loss Malaise and fatigue Fever Anorexia Lymphadenopathy Headache and convulsion (intracranial metastasis) Shortness of breath (bronchogenic carcinoma) Dermatologic conditions: Ichthyosis palmar/plantar hyperkeratosis Less frequently EGR co-present [wikidoc.org]

• Inflammation

  […] cross-reacting tumor antigens which causes an inflammatory skin disorder, (2) transformation of normal skin proteins by tumor thus making them antigenic, (3) deposition of immune complexes with tumor antigens at the basement membrane zone and induction of inflammation [ijdvl.com]

  Our case might support the hypothesis of cutaneous inflammation induced by crystallization of glutamine compounds in the skin. Tumor therapy was palliative by radiation. [symbiosisonlinepublishing.com]

• Goiter

  Iron Deficiency Anemia Nodular Goiter Cutaneous Lupus Erythematosus Leukocytoclastic Vasculitis [link.springer.com]

• Arthritis

  Moreover, a parallel evolution of the two affections (EGR and rheumatoid arthritis) was observed in our patient. [ijdvl.com]

  Br J Dermatol. 2007, 127:773-775. 10.1111/j.1365-2133.2006.07746.x Endo Y, Fujisawa A, Tanioka M, Miyachi Y: Erythema gyratum repens preceding the onset of rheumatoid arthritis. [cureus.com]

  […] extremely rare EGR with concomitant skin disease Pityriasis rubra pilaris, psoriasis, ichthyosis, CREST (calcinosis, Raynaud phenomenon, esophageal motility disorder, sclerodactyly, and telangiectasia) syndrome, virginal breast hypertrophy, rheumatoid arthritis [wikidoc.org]

• Cutaneous Manifestation

  Keywords Lyme Disease Borrelia Burgdorferi Cutaneous Manifestation Tick Bite Internal Malignancy These keywords were added by machine and not by the authors. [link.springer.com]

  REVIEW OF LITERATURE In 1925 Rothman1 wrote a comprehensive review on the subject of cutaneous manifestations in patients [jamanetwork.com]

  Clin Dermatol. 2011, 29:541-547. 10.1016/j.clindermatol.2010.09.022 Pipkin CA, Lio PA: Cutaneous manifestations of internal malignancies: an overview. [cureus.com]

  Cutaneous manifestations of internal malignancy. Am J Clin Dermatol. 2006;;7:71–84. [PubMed] [Google Scholar] 6. Kiyohara T, Kumakiri M, Kobayashi H, et al. [ncbi.nlm.nih.gov]

• Pruritus

  The intense pruritus can be debilitating and usually urges the patient to go to the emergency department. [wikidoc.org]

  The rash was associated with extreme pruritus, erythema, and scaling (Figures 1 and 2). Additional symptoms included a 22-lb weight loss, progressive fatigue, anorexia, and intermittent vomiting. [ncbi.nlm.nih.gov]

• Urticaria

  This is the first case of erythema gyratum repens in which there was erythema annulare centrifugum, vesicular erythema annulare centrifugum, and urticaria. [jamanetwork.com]

  Lupus gyratum repens rare Lupus erythematosus variant Neutrophilic figurated erythema may be associated with leukemia/lymphoma of childhood Psoriasis rarely with figurated erythemas Sweet-Syndrom figurated erythemas possible, neutrophilic dermatosis Urticaria [symbiosisonlinepublishing.com]

  Urticarial in appearance, ringed, arcuate figures Eruption migrate at a slower rate (2 -3 mm/d) reaching up to 10 cm in diameter with central clearing Cover only a small percentage of the total body surface Annular or polycyclic lesions which may begin as urticaria-like [wikidoc.org]

• Purpura

  Classic symptoms of urticarial vasculitis, such as painful burning sensation, residual purpura, and pigmentation, were not present. [ijdvl.com]

  Erythema Gyratum Repens-Like Purpura in a Patient with Sjögren Syndrome. Case Rep Dermatol. 2017 May-Aug. 9 (2):40-43. [QxMD MEDLINE Link]. Jouary T, Lalanne N, Stanislas S, Vergier B, Delaunay M, Taieb A. [emedicine.medscape.com]

  "Erythema Gyratum Repens-Like Purpura in a Patient with Sjögren Syndrome". Case Rep Dermatol. 9 (2): 40–43. doi:10.1159/000477375. PMC 5498950. PMID 28690517. ↑ 9.0 9.1 Günther R, Nasser S, Hinrichsen H, Fölsch UR (2002). [wikidoc.org]

• Irritability

  She reported no known allergies and denied recent irritation or substance exposure to the affected area. Treatment included daily over-the-counter hydrocortisone cream but failed to provide symptomatic relief. [karger.com]

• Burning Sensation

  Classic symptoms of urticarial vasculitis, such as painful burning sensation, residual purpura, and pigmentation, were not present. [ijdvl.com]

This workup should include complete blood counts, urine analysis, and age appropriate cancer screening. CT scan of the chest, abdomen, and pelvis must also be considered if other tests are not diagnostic. [ozarkderm.com]

We therefore did a thorough paraneoplastic workup including computed tomography of thorax, abdomen, and pelvis; positron emission tomography/computed tomography; upper and lower gastrointestinal endoscopy; tumor markers; and blood tests including lactate [jaadcasereports.org]

Erythema gyratum repens is diagnosed clinically by its characteristic skin eruption and an urgent thorough paraneoplastic workup should be initiated to look for internal malignancies. [wikidoc.org]

Treatment of EGR is difficult and aimed at treatment of the underlying malignancy. Steroids (systemic and topical), vitamin A and azathioprine are frequently ineffective. [casereports.bmj.com]

Treatment Medical Therapy Treatment of erythema gyratum repens, and its associated intense pruritus depends on the recognition and treatment of the underlying malignancy[13] Symptomatic management: Hydroxyzine for itching, ibuprofen and oxycodone for [wikidoc.org]

Treatment: Therapy is directed at treating the underlying malignancy. Treatment of the rash itself is often disappointing. Topical steroids provide minimal relief in most cases. [ozarkderm.com]

This case report details the appearance, epidemiology, diagnosis, and treatment of EGR. Prompt identification of EGR is essential, as the rash often precedes the diagnosis of malignancy by several months. [escholarship.org]

What is the treatment for erythema gyratum repens? The treatment for erythema gyratum repens is to identify and treat the primary malignancy. [dermnetnz.org]

[…] left untreated, the debilitating pruritus could persist until the patient dies[13] Prognosis depends on the type of the underlying tumor and the probability of its treatment. [wikidoc.org]

Age Erythema gyratum repens usually occurs in patients older than 40 years, with a mean age of 63 years, but it has been reported to occur from age 16-77 years. [20] Prognosis The prognosis for erythema gyratum repens depends on the underlying illness [emedicine.medscape.com]

Prognosis is usually guarded in DLBCL; however, it is not highly malignant in the index case as he has been enduring the ailment for the last 3 years. Management of EGR includes recognition and treatment of underlying malignancy. [e-ijd.org]

CONCLUSION: The etiology of erythema gyratum repens is unknown, although an immune response is postulated. Treatment involves treating the underlying malignancy. Find Full Text Links for this Article Trending Papers [read.qxmd.com]

Definition / general Various erytematous eruptions with a curvilinear ("gyrate") appearance: Erythema annulare centrifugum: most common gyrate erythema, but etiology unknown; may grow over weeks, resolves in 1 - 2 months Erythema marginatum rheumaticum [pathologyoutlines.com]

The etiology of erythema gyratum repens remains unclear. Recently, Forrester discussed a possible relationsship to L-glutamine cristallization in living tissues. [symbiosisonlinepublishing.com]

Conclusion: The etiology of erythema gyratum repens is unknown, although an immune response is postulated. Treatment involves treating the underlying malignancy. Similar articles Erythema gyratum repens: a paraneoplastic eruption. [pubmed.ncbi.nlm.nih.gov]

Almost one-third of all non-paraneoplastic erythema gyratum repens cases have been considered idiopathic. [1],[2],[3] Erythema gyratum repens is considered as an immunologically driven skin disease, however, its etiology still remains poorly understood [ijdvl.com]

This case report details the appearance, epidemiology, diagnosis, and treatment of EGR. Prompt identification of EGR is essential, as the rash often precedes the diagnosis of malignancy by several months. [escholarship.org]

We discuss the appearance of EGR, its epidemiology, and its diagnostic and treatment implications. [ncbi.nlm.nih.gov]

The current concept of pathophysiology assumes a tumorinduced humoral and/ or cellular immune response resulting in a cross-reactivity to skin or deposition of tumor antigen-antibody immunocomplexes along the basement membrane [2]. [symbiosisonlinepublishing.com]

Pathophysiology The pathogenesis of erythema gyratum repens remains unknown. The following hypotheses have been proposed: First, tumor antigens may form and cross-react with endogenous skin antigens. [emedicine.medscape.com]

[…] tuberculosis, bullous pemphigoid, linear IgA disease, and hypereosinophilic syndrome, cryptogenic organizing pneumonia[11] Drug-induced EGR Azathioprine with type I autoimmune hepatitis[9] Interferon given for hepatitis C virus–related chronic hepatitis[10] Pathophysiology [wikidoc.org]

Prevention Primary prevention: There are no primary preventive measures available for erythema gyratum repens Secondary prevention: If the thorough screening after Erythyma gyratum repens diagnosis detected the malignancy in its earliest stages. [wikidoc.org]

Improvement Performance Measures Perioperative Care and Consultation Pharmacoeconomics Pharmacoepidemiology Pharmacogenetics Pharmacy and Clinical Pharmacology Physical Medicine and Rehabilitation Physical Therapy Physician Leadership Poetry Population Health Preventive [jamanetwork.com]

The condition may precede a symptomatic appearance of internal malignancy, and therefore provides a unique opportunity to prevent additional morbidity and mortality secondary to undetectable cancer growth. [karger.com]