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   Case Report
   Discussion
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CASE REPORT
Year : 1999  |  Volume : 65  |  Issue : 6  |  Page : 283-284

Erythema annulare centrifugum due to candida infection




Correspondence Address:
Mathew P Alex


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Source of Support: None, Conflict of Interest: None


PMID: 20921688

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How to cite this article:
Alex MP, Mohan L, Singh K K, Mukhija R D. Erythema annulare centrifugum due to candida infection. Indian J Dermatol Venereol Leprol 1999;65:283-4

How to cite this URL:
Alex MP, Mohan L, Singh K K, Mukhija R D. Erythema annulare centrifugum due to candida infection. Indian J Dermatol Venereol Leprol [serial online] 1999 [cited 2019 Jun 20];65:283-4. Available from: http://www.ijdvl.com/text.asp?1999/65/6/283/4841





  Introduction Top


The term 'erythema annulare centrifugum' was first used by Darier in 1916, who described multiple ring shaped lesions of indurated erythema.

Erythema annulare centrifugum is one of the chronic annular and figurate eruptions which is grouped broadly under annular erythemas, where, in a large majority of cases the aetiology remains obscure even after prolonged observation and investigation.[1] Examples associated with diverse trigger factors have been quite convincingly demonstrated, which include factors such as tinea infection,[2] ingested fungus,[3] ascaris infection,[4] Candida infection,[5] drug hypersensitivity,[6] carcinoma, blood dyscrasia, etc.


  Case Report Top


A 3-month-old, healthy and well built male child presented with the complaint of erythematous ring shaped lesions over the trunk and buttocks for 1 month. There were erythematous moist denuded lesions in the flexural folds of neck, the perianal region, groins and curdy white membrane over the tongue.

The skin lesions began as small pink, erythematous papules which slowly enlarged to form a ring, as the centre flattened and faded. The edges were elevated, erythematous and easily palpable with mild scaling. A detailed history and examination did not reveal any evidence of trichophyton infection, ascaris infection, blood dyscrasia, carcinoma, drug hypersensitivity or any immunological abnormality. There was no haematological abnormality. Direct microscopic examination of skin scrapings and wet smears from perianal region and neck flexures showed budding yeast with hyphae and pseudohyphae. Cultures also revealed Candida albicans.

Histopathology of skin lesions was suggestive of erythema annulare centrifugum.

The patient was given nystatin 200,000 units per day orally in 4 divided doses and topical antifungal for 15 days. No treatment was given for lesions of erythema annulare centrifugum. The lesions started resolving in 8 to 10 days and completely resolved in 15 days. There has been no recurrence for over 1 years now.


  Discussion Top


Erythema annulare centrifugum is one among the various eruptions where the aetiology remains obscure. Candida infections and mould allergy may be one among the various causes. A relationship is established as in the above case where the eruption of erythema annulare centrifugum was associated with candida infection and the resolution of the lesions after anticandidal therapy. The resolution and absence of recurrence of lesions after anticandidal therapy indicates that it may be an effective therapy although further trials need to be conducted.

This case is reported because of the association with candida infection and paucity of cases in literature.



 
  References Top

1.Litoux P, Essai Sur La. Physiopathologic des erythemes annulaires centrifuge. Ann Dermatol Syphiligr 1987;114:709-715.  Back to cited text no. 1    
2.Jillson OF. Allergic confirmation that some cases of erythema annulare centrifugum are dermatophytids. Arch Dermatol Syphilol 1954;70:355-359.  Back to cited text no. 2    
3.Shelly WB. Erythema annulare centrifugum. Arch Dermatol 1964;90:54-58.  Back to cited text no. 3    
4.Hendricks AA, Lu C, Eltenbein GJ, et al. Erythema annulare centrifugum associated with ascariasis. Arch Dermatol 1981;117:582-585.  Back to cited text no. 4    
5.Shelly WB. Erythema annulare centrifugum due to Candida albicans. Br J Dermatol 1965;77:383-384.  Back to cited text no. 5    
6.Ashurst PJ. Erythema annulare centrifugum. Arch Dermatol 1967;95:37-39.  Back to cited text no. 6  [PUBMED]  [FULLTEXT]




 

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