Erythema
Gyratum Repens, another cutaneous marker of malignancy./
Eritema Gyratum Repens,
otro marcador cutaneo de malignidad.
DATA-MEDICOS
DERMAGIC/EXPRESS 2-(93)
19 Abril 2.000 19 April 2.000
~ Eritema Gyratum Repens, otro marcador cutaneo de malignidad ~
~ Erythema Gyratum Repens, another cutaneous marker of malignancy~
EDITORIAL ESPANOL
=================
Hola amigos de la red DERMAGIC de nuevo con ustedes. El tema de hoy:
el ERITEMA GYRATUM REPENS. En esta ocasion La historia selecciono en el
año 1.953 a Gammel quien fue el que describio el primer caso de
esta enfermedad, unas lesiones en piel acompañadas de un adenocarcinoma
de seno. Despues de esta primera descripcion HASTA el año 1.992
se siguieron reportando OTROS 41 casos mas de ERITEMA GYRATUM REPENS asociado
a malignidad. Solo en contadas ocasiones NO HA HABIDO asociacion con cancer,
y por ello hoy dia es considerado UN MARCADOR CUTANEO DE MALIGNIDAD.
En muchos casos el Eritema aparecio meses, incluso años antes
de detectarse la neoplasia. El tratamiento: UNA BUSQUEDA total de cualquier
proceso maligno y su ELIMINACION. Una vez eliminada la causa desaparecera
el ERITEMA GYRATUM REPENS. La piel sigue siendo un ESPEJO de nuestra alma,
en estas referencias asi queda demostrado. Espero las disfruten.
Saludos a todos,,,
Dr. Jose Lapenta R.
EDITORIAL ENGLISH
=================
Hello friends of the net DERMAGIC again with you. Today's topic: the
ERYTHEMA GYRATUM REPENS. In this occasion The history selects in the year
1.953 to Gammel who was the one that described the first case of this illness,
some lesions in skin accompanied by a breast adenocarcinoma. After this
first description UNTIL the year 1.992 were continued reporting OTHER 41
cases of ERITEMA GYRATUM REPENS associated to malignancy. Alone in
counted occasions there has not BEEN association with cancer, and for it
A CUTANEOUS MARKER OF MALIGNANCY is considered nowadays. In many
cases the Erythema appeared months, even years before being detected the
malignancy. The treatment: A total SEARCH of any wicked process (cancer)
and their ELIMINATION. Once eliminated the cause, the ERYTHEMA GYRATUM
REPENS will disappear. The skin continues being a MIRROR of our soul, in
these references it is demonstrated this way. I wait you enjoy these references.
Greetings to all !!!
Dr. Jose Lapenta R.,,,
==================================================================
REFERENCIAS BIBLIOGRAFICAS / BIBLIOGRAPHICAL REFERENCES
==================================================================
1.) Erythema gyratum repens: A paraneoplastic eruption; Clinical review
2.) Cutaneous manifestations of cancer.
3.) Erythema gyratum repens in association with renal cell carcinoma.
4.) Erythema gyratum repens: another case of a rare disorder but no
new insight into pathogenesis.
5.) Cutaneous paraneoplastic syndromes in solid tumors.
6.) Erythema gyratum repens unassociated with underlying malignancy.
7.) Erythema gyratum repens-like eruption in a patient with Sjogren
syndrome.
8.) Paraneoplastic bullous pemphigoid resembling erythema gyratum repens.
9.) Eruption resembling erythema gyratum repens in linear IgA dermatosis.
10.) Erythema gyratum repens associated with hypereosinophilic syndrome.
11.) Erythema gyratum repens. A case studied with immunofluorescence,
immunoelectron microscopy and immunohistochemistry.
12.) Erythema gyratum repens: direct immunofluorescence microscopic
findings.
13.) Erythema gyratum repens without underlying disease.
14.)Reactive erythemas: erythema annulare centrifugum and erythema
gyratum
repens.
15.) Subcorneal accumulation of Langerhans cells in erythema gyratum
repens.
16.) Erythema gyratum repens in a healthy woman.
17.)[Gammel's non-paraneoplastic erythema gyratum repens].
18.) [Erythema gyratum repens type eruption].
19.) A mechanism of peripheral spread or localization of inflammatory
reactions--role of the localized ground substance adaptive phenomenon.
20.) Episodic erythema gyratum repens with ichthyosis and palmoplantar
hyperkeratosis without signs of internal malignancy.
21.) Erythema gyratum repens. A cutaneous marker of malignancy.
22.) Bullous pemphigoid with figurate erythema associated with carcinoma
of the bronchus.
23.) Erythema figuratum versus erythema gyratum repens.
24.) Erythema gyratum repens, a stage in the resolution of pityriasis
rubra
pilaris?
25.)[Erythema gyratum repens--a paraneoplastic dermatosis].
26.)Erythema gyratum repens unassociated with internal malignancy.
27.) Erythema gyratum repens.
28.) Gyrate erythema.
29.) Infantile epidermodysplastic erythema gyratum responsive to imidazoles.
A new entity?
30.) Erythema gyratum repens with associated squamous cell carcinoma
of the lung.
31.) [Cutaneous paraneoplastic syndromes].
32.) [Erythema gyratum repens and primary bronchial cancer. Disappearance
of the dermatosis under general corticoid therapy].
33.) [Erythema gyratum repens of Gammel and Hodgkin's disease].
34.) Erythema gyratum repens-like figurate eruption in bullous pemphigoid.
35.) [Erythema gyratum repens].
36.) [Erythema gyratum repens].
37.) Erythema gyratum repens: spontaneous resolution in a healthy man.
38.) Erythema gyratum repens with pulmonary tuberculosis.
39.) [Gammel's erythema gyratum repens and acquired ichthyosis associated
with esophageal carcinoma].
40.) [Erythema gyratum repens or Gammel paraneoplastic syndrome. A
case with
epidermoid carcinoma developed on a megaesophagus].
41.) Erythema gyratum repens--an immunologically mediated dermatosis?
42.) Erythema gyratum repens with metastatic adenocarcinoma.
43.) [Erythema gyratum repens (Gammel's syndrome)]
44.) Figurate and bullous eruption in association with breast carcinoma.
45.) [Erythema gyratum repens associated with bronchial carcinoma]
46.) Erythema gyratum repens. Reports of two further cases associated
with
carcinoma.
47.) Carcinoma of the breast, pemphigus vulgaris and gyrate erythema.
48.) [Premycotic erythema simulating erythema gyratum repens].
49.) [An unusual paraneoplastic syndrome: erythema "gyratum repens"
or Gammel's syndrome].
50.) [An unusual paraneoplastic syndrome: erythema gyratum repens.
Its relation with bronchial cancer].
=============================================================
=============================================================
1.) Erythema gyratum repens: A paraneoplastic eruption; Clinical review
=============================================================
SOURCE: J AM ACAD DERMATOL 1992;26:757-62.
Alan S. Boyd, MD, Kenneth H. Neldner, MD, and Alan Menter, MD Lubbock
and
Dallas, Texas
Erythema gyratum repens is a slowly expanding, mildly scaling dermatosis
with a "wood-grain" pattern and is seen in patients with an underlying
malignancy. To date oflly 49 cases have appearcd in the literature,
41 of
which (84%) were associated with a neoplasm, most commonly of the lung.
Several patients also had pruritus, palmoplantar keratoderma, ichthyosis,
vesiculobulbus lesions, and/ or eosinophilia. Histopathologic findings
are
nonspecific. The skin findings usually disappear with therapy for the
underlying malignancy. (J AM ACAD DERMATOL 1992;26:757-62.)
The skin may be the first organ to heraLd {he presence of a visceral
malignancy. Paraneoplastic eruptions seen with cancer include acanthosis
nigricans, acquired ichthyosis, pancreatic fat necrosis, migratory
thrombophlebitis, Sweet's syndrome, hypertrichosis lanuginosa acquisita,
and others, but one of the most specific dermatoses associated with
underlying neoplasia is that of erythema gyratum repens (EGR). We discuss
this dermatosis and review the literature.
HISTORY
=======
Gammel1 described the first case of EGR in 1953. His patient, a
55-year-old woman, developed a scaling, pruritic eruption on her trunk
and
extremities reminiscent of "knotty cypress wood grain." The eruptions
was
noted to extend about 1 cm per day. A palpable axillary lymph node
revealed
metastatic adenocarcinoma of the breast. A radical mastectomy was
performed that led to fading of the eruption within 48 hours and complete
clearing by 6 weeks. Neither the eruption nor the tumor recurred. The
author believed this distinctive eruption had been caused by a carcinotoxin
to which the host was allergic. He named it "erythema gyratum repens"
(repens from the Latin meaning to crawl or creep).2
Since this initial description, at least 48 additional patients have
been
reported.3-46 With a few exceptions,28, 31,35,36,40,42,46 all have
been afflicted with an underlying malignancy, most commonly of the lung.
Figurate erythemas have been known to occur With neoplasia,47 but EGR is
the most specific and may be the most distinctive.
CLINICAL FINDINGS
=================
EGR displays concentric erythematous bands48 predominantly on the trunk
and
extremities. The hands, feet, and face are usually spared.2'49
The pattern of EGR has been described as wood-grained,17' 25, 28, 35,
43
serpiginous,25 zebralike,2' 20 cypress rings,22 gyrate,43 whorled,43
and
swirls of rope25 (Fig. 1, B). The expanding borders are usually macular
but may occasionally be palpable.20 Scale is usually present14,20 and
trails the leading edge of the eruption42. The eruption of EGR
moves rapidly across the surface of the skin, usually about 1 cm per
day.14
EGR may involve the entire body.12'20'25'26'40 Saika et al.23 reported
a
patient in whom solely right-sided truncal lesions developed with
underlying intrahepatic metastases from an adenocarcinoma of the colon.
An
overlying solitary flank lesion in a patient with ipsilateral
hypernephroma has also been observed by one of us (A. M.).
Table 1 lists the associated skin findings in these patients. Most patients
experienced some degree of pruritus.20 Ichthyosis and palmar/plantar
hyperkeratosis were also noted in 16% (8 of 49) and 10% (5 of 49) of
the
patients, respectively. Three patients also had bullous pemphigoid,23,35,44
one had pemphigus vulgaris,30 and three had unspecified vesicles and
bullae7, 13, 14 during the course of the disorder.
An approximately 2:1 male-to-female ratio was observed. The average
age was
63 years and thus far alL patients have been white. Most patients (25)
had
the onset of their eruption an average of 9 months before their malignancy
was diagnosed (range 1 to 72 months). Four patients developed EGR an
average of 9 months after their tumor was detected and in two cases16,41
the eruption and neoplasm occurred simultaneously.
Table II outlines the underlying malignancies (if any) in these patients.
Lung cancer was the most common (16 patients [32%]), followed distantly
by
esophagus (4 patients [8%]) and breast (3 patients
[6%]). In three patients a metastatic malignancy was detected but the
primary site could not be identified.14,22,25 Lymphoreticular
cancers
were rare.19,37 Six patients did not have an underlying malignancy,31,35,40,42,46
and in two other cases tuberculosis28 and the
CREST syndrome36 were believed to be the cause.
Laboratory evaluations were performed in some cases. Many patients had
peripheral eosinophilia as high as 59%.29 Eosinophilia of the bone
marrow
has also been described.7,46 Decreased T-ce1126'30 and increased
B-ce1126 populations have been reported, as have normal percentages
for
both.31 Stankler31 demonstrated normal T-cell function in a patient
with EGR but no underlying malignancy. Decreased serum levels of C3 and
increased luteinizing hormone and follicle-stimulating hormone were reported
in one patient.26
=============================================================
Table 1. Skin findings in 49 patients with erythema gyratum repens
=============================================================
% of |
Affected | disordes
patients |
-------------------------------------------------------------
50 Pruritus*
16 Ichthyosis 22' 26, 29, 40,41,43,45,46
lo Palmar/plantar hyperkeratosis
6,42,45,46
8 Pityriasis rubra pilaris 20,
40
6 Psoriasiform lesions10, 39,40
6 Vesicles/bullae7' 13, 14
6 Bulbus pemphigoid 23,35'44
2 Pemphigus vulgaris 30
2 Discoid lupus erythematosus 40
*References 1,3-7, 10, 12, 14, 17,21,22,25,27-29,37, 38,40,41,43, 45,
46, 48.
-------------------------------------------------------------
=============================================================
Table II. Underlying malignancies associated with erythema
gyratum repens*
=============================================================
% |
Patients |
TyPe
-------------------------------------------------------------
32 Lung4, 9, 10, 15-18, 21,26,37,39,41,43,44,45
12 None31,35,40,42,46
8 Esophagus27, 29,32, 33
6 Breast,1, 3, 30 unknown metastatic
neoplasm 4, 22, 25
4 Cervix,5,7 pharynx,8,34 stomach11,13
2 Anus,24 bladder,20 bowel,23 Hodgkins
disease,38 myeloma,19
pancreas,41, prostate,20 tongue,6 uterus 12
--------------------------------------------------------------
*One patient each also had tuberculosis28 and CREST syndrome.36
--------------------------------------------------------------
HISTOPATHOLOGY
EGR is classified among the superficial erythemas50 and as such tends
to
demonstrate generally nonspecific histopathologic features. Mild to
moderate hyperkeratosis, parakeratosis, and spongiosis are seen.43,49,
50 Acanthosis, follicular plugging, liquefactive epidermal celLs, and
epidermopoiesis of neutrophils and eosinophils have been described.7
The dermal vessels are surrounded by a lympho-histiocytic infiltrate
with
occasional eosinophils.28, 37, 40, 43, 50 Mast cells may also
be seen.28
The capillary endothelium may appear swollen7 and vascular proliferation
has been described.14,28 Frank vasculitis is absent. Pigmentary
incontinence45 and papillary dermal edema49 may also be seen. Subepidermal
bullae with a sparse eosinophil infiltrate was described in a patient
with
EGR and bulbus pemphigoid.35
Holt and Davies26 described a patient with bronchogenic carcinoma who
had
IgG and C3 deposits at the basement membrane zone detected by direct
immunofluorescence of both lesional and uninvolved skin. Indirect
immunofluorescence and immunofluorescence of metastatic nodal deposits
were negative. Other investigators have found negative direct and indirect
immunofiuorescence in biopsy specimens of EGR.39,46 Levine et al.43
described a patient Erythema gyratum repens with no immune deposits
at the basement membrane zone but IgM deposition on epidermal nuclei. Phenotyping
of the infiammatory infiltrate in EGR demonstrated B celís and macrophages;
no T celís were found.26
DISCUSSION
===========
Differential diagnosis of the figurate erythemas
------------------------------------------------
Erythema annulare centrifugum (EAC) is morphologically similar to EGR
and
some authors believe a close relation exists between the two disorders.7
EAC usually is manifested by arcuate, polycyclic erythematous lesions
that
expand slowly48 and clear centrally; it may be pruritic.49 EAC differs
from
EGR in that the former is slightly palpable and "moves" much more slowly.20
Histopathologic examination shows that EAC is a deep and superficial
erythema50,51 with a lymphohistiocytic "coat-sleeve" arrangement around
blood vessels,50 mild spongiosis, and parakeratosis.49
EAC may 2,48 or may not2,52 be related to an underlying disease. It
has
been reported in association with malignancies48 but also with infections
and drug intake.2,48,53 Lesions may persist indefinitely or resolve
within
a few days.
Erythema chronicum migrans (ECM) is an annular eruption precipitated
by
the bite of an Ixodes tick and caused by infection with Borrelia
burgdorferi.2,48,49 The lesions begin as erythematous papules that
enlarge
in a circular, expansile pattern to form a red, raised, scaleless eruption
several centimeters in width.48 This usually begins several days to
weeks
after the tick bite. Serum antibodies directed against Borrelia antigens
may be found.
Erythema marginatum rheumaticum is usually associated with rheumatic
fever in children and is rarely seen today.2 This eruption shows swift
spread-irng, erythema, and minimal induration. However, it displays no
scaling, has no symptoms, is evanescent, and demonstrates a neutrophilic
infiltrate on histologic examination 49,51 Patients with glucagon-producing
islet cell tu-mors of the pancreas may have necrolytic migratory erythema.
Lesions usually begin on dependant parts of the body, periorally and perigenitally.
Arcuate and circinate red plaques with erosions, vesicles, necrosis, and
desquamation are present.48 Additional diseases that may occasionally enter
the differential diagnosis include subacute cutaneous discoid lupus erythematosus,
tinea corporis (especially tinea imbricata), psoriasis, pityriasis rubra
pilaris, familial annular erythema, and keratolytic winter erythema.
Etiology
========
The cause of EGR is unclear. Gammel1 believed that the underlying tumor
altered organ proteins, thereby producing endogenous allergens and
creating
a state of hypersensitivity to specific tumor antigens. Church10 injected
suspensions of his patient's tumor (lung), unaffected pulmonary tissue,
and
skin intradermally into a recovered patient. In a similar experiment
Leavelí et al.14 performed an Ouchter-lony gel ditfusion with
their
patient's serum and a homogenate of his tumor (undifferentiated
adenocarcinoma-type unknown). Both produced negative results. Holt
and Davies,26 the only investigators to demonstrate positive immunofiuorescence
of the basement membrane in skin biopsy specimens of EGR, proposed
three
possibilities: tumor neoantigens may invoke antibody production that
cross-react with endogenous skin antigens, the tumor products may alter
certain skin antigens rendering it susceptible to immunologic attack,
and
tumor antigen-antibody complexes may form with subsequent cutaneous
deposition. Barber et al.28 agreed that immune complex deposition may
be
operative but not neeessarily involve tumor antigens exclusively.
Evaluations of the cellular arm of the immune system in EGR have been
sparse. Investigators do not believe these lymphocyte subsets play
a
significant etiologic role in the eruption.26 Jacobs et al.30 noted
a
peripheral T-cell deficiency in their patient and postulated that a
compensatory B-cell hyperactivity existed. Peripheral blood lymphocytes
in
one patient were not stimulated by phytohemagglutimn, tumor extract
(lung), or involved skin extract.26
It seems clear that whatever factors are involved in the production
of
this eruption emanate from the underlying tumor. These factors may
be
produced from solid as well as hematopoietic tumors. Inherent in patients
who develop EGR is a predisposition to react in such a manner when
affiicted with cancer. Such a susceptibility could involve the human
lymphocyte antigen (HLA) system, tumoral antigen production, and/or
ground
substance alterations. Specific HLA antigens have been reported to
occur to a significantly greater extent in patients with malignancies of
the cervix,54 testis,55 and thyroid,56 as well as in non-Hodgkin's lymphoma,57
Burkitt's lymphoma,58 and multiple myeloma.59 An interesting feature of
the HLA antigens is their close relation to tumor antigens.60 These two
groups of polypeptides are believed to be structurally similar with an
association
existiing between the genes expressing both. Specific alleles among
patients with cancer may render them more susceptible to the development
of EGR. Second, the pathogenesis of EGR may involve a localized ground
substance adaptive phenomenon. In this model granulocytes release connective
tissue active peptides, which, in turn, stimulate fibroblast proliferation
to produce ground substance with increased viscosity. 61 Thus inflammatory
mediators are impeded from tissue spread and "walled off." EGR might
result
from a similar phenomenon involving spread of the erythematous rings
through stroma, which is unable to "wall off,' the attendant inflammation.
Clearing of the eruption results from a subsequent halt of this process
and clearance of the inflammatory mediators.61 Moore62 noted that the
morphologic features of EGR were similar to the patterns of aggregating
slime mould and the Belousez-Zhabotinskii chemical reaction, processes
in
which reaction or diffusion systems are also operative.
Additional findings
--------------------
Five patients with EGR (10%) also had palmo-plantar keratoderma. In
three,
no underlying malignancy was detected,42,46 one had lung cancer,45
and one
patient had a tongue carcinoma.6 Keratotic involvement of the palms
and
soles has been described previously in association with esophageal
cancer63 and Bazex syndrome.64 Therefore it is not surprising that
hyperkeratotic activity should appear in a subset of patients with a paraneoplastic
eruption. These findings may be purely coincidental, but the high prevalence
of palmoplantar thickening would make an association seem plausible.
Three patients had associated bullous pemphigoid,23,35,44 one had pemphigus
vulgaris,30 and three had vesiculobulbus eruptions not otherwise
specified.7,13, 14 All but one of these had an underlying malignancy,35
and no specific cancer was represented more than once. The association
between cancer and pemphigoid/pemphigus has been speculated on for
many
years, however, it is currently believed that a link probably does
not
exist.65,66 Because virtually all patients with EGR have had an underlying
malignancy, the question arises, what of those who do not? Barber et al.28
published the first case of a patient with this eruption and pulmonary
tuberculosis. Although their photograph fails to show the classic "knotty
cypress" pattern, the patient's course appears consistent with EGR. Shortly
thereafter, Stankler31 described a healthy man with a 17-month history
of
a gyrate erythema believed to be consistent with EGR that subsequently
resolved. Examination did not reveal a malignant process. No photographs
were provided. Ingber et al.36 and Juhlin et al.46 described patients
with
the CREST syndrome and palmoplantar hyperkeratosis, respectively; however,
their photographic documentation is questionable for EGR. In 1985 Langlois
et al. 42 reported a patient with the classic eruption of EGR with
a
negative evaluation and lack of malignancy at autopsy. The patient
had had
an unexplained 30-pound weight loss. Risk factors for neoplasia in
this
patient were not discussed. Finally, Cheesbrough and Williamson40 present
the best evidence for EGR unassociated with a malignancy. Their two
patients had a characteristic eruption, exhaustive work-ups, lengthy
follow-up (12 and 60 months), and, importantly, no signs or symptoms
referable to an underlying cancer. Therefore it seems clear that a
few
patients with EGR and no underlying malignancy do exist. However, patients
who develop the typical eruption of this disorder should be assumed
to have
an underlying cancer until proven otherwise.
TREATMENT
=========
The most effective therapy for EGR is an exhaustive search for an
underlying malignancy with treatment of the primary cause. Resolution
of the
Erythema gyratum repens eruption has been noted after surgery, chemother-apy,
or radiotherapy.1, 3,4,9, 10'25'38 After treatment of the cancer, additional
therapy for the
eruption includes topical20, 46 and systemic steroids,25, 37,42
radiotherapy,24 and azathioprine.24 Failure of topical steroids 22,24
and
vitamin A administration42 has been reported.
REFERENCES
==========
1. Gammel JA. Erythema gyratum repens.
AMA Arch Derm Syph 1953;66:494-505.
2. Harrison PM. The annular erythemas.
Int J Dermatol 1979;18:282-90.
3. Purdy MJ. Erythema gyratum repens.
Arch Dermatol 1 959;80:590- 1.
4. Schneeweiss J, Goid SC. Erythema gyratum repens.
Proc Roy Soc Med 1959;52:367-8.
5. Duperrat B, Guilaine J, Demay C. Erythema gvratum: en rapport avec
un
carcinome cervical métastatique. Bulí Soc Franc Derm
Syph 1961;68:20-1.
6. Duperrat B, Pringuet R, David V. Erythema gyratum repens.
Bulí Soc Franc Derm Syph 1961;68:578-82.
7. Van Dijk E. Erythema gvratum repens.
Dermatologica 1961;123:301-10.
8. Storck H, Schnyder UW, Schwarz K. Erythema gyratum repens bei
hypopharynxcarcinom. Dermatologica 1962;124:289-93.
9. Caldwell 1W. In discussion of Church RE. Bronchiolar carcinoma
presenfing as erythema gvratum perstans. Proc Roy Soc Med 1963;56:905.
10. Church RE. Bronchiolar carcinoma presenting as erythema gyratum
perstans. Proc Roy Soc Med 1963;56:904-5.
11. Woerdeman MJ. Erythema gyratum repens.
Dermatolog-ica 1964;128:391-2.
12. Le Coulant P, Texier L, Maleville J, et al. Erythema gyratum repens.
Buil Soc Franc Derm Syph 1966;73:235-6.
13. Pevny 1. Erythema gyratum repens.
Z Raut Geschlecbtslcr 1 966;40:26~70.
14. Leavelí UW, Winternitz WW, Black JR. Erytbema gyratum repens
and
undifferentiated carcinoma. Arch Derma-tol 1967;95:69-72.
15. Miguérés J, Jover A, Layssol M, et al. Un syndrome
para-néoplasique
rare: l'érythéme gyratum repens: Ses rapports avec le
cancer bronchique. J
Franc Med Chir Thor 1967;212:313-24.
16. Pokorny' M, Hilla M. Erythema gvratum repens.
Cesk Dermatol 1969;44:200-3.
17. Solomon R. Erytbema gyratum repens [Letter].
Arch Dermatol 1969;lO0:639.
18. Hochleitner H, Bartsch G, Zelger J. Erythema gyratum repens bei
Bronchuscarcinom. Rautarzt 1970;21:1 16-9.
19. Thivolet J, Gallois P, Perrot R. Une dermatose paranéc>
plasique
m6connue: l'érythema giratum repens. Rev Lyon Med 1970;19:789-95.
20. Thomson J, Stankler L. Erythema gyratum repens.
Br J Dermatol 1970;82:406-1 1.
21. Connor BL. Erythema gyratum repens: case presentafion.
Trans St Johns Hosp Dermatol Soc 1972;58:323-4.
22. Touraine R, Revaz J, Lepine J, et al. Syndrome paraneo-plasique
associant ichtyose généralisé et érythéme
annu-laire.
Bulí Soc Fr Derm Syph 1972;79:623-6.
23. Saika NK, MacKie RM, McQueen A. A case of bulbus pemphigoid and
figurate erythema in association with met-astatic spread ofcarcinoma.
Br J Dermatol 1973;88:33 1-4.
24. Lukowska 1, Silny W. Erythema gyratum repens jako schorzenie
paranowotworowe. Przegl Dermatol 1974; 61:785-9.
25. Skolnick M, Mainman BR. Erythema gyratum repens with metastatic
adenocarcinoma. Arch Dermatol 1975; 111:227-9.
26. Holt PJA, Davies MG. Erythema gyratum repens an ímmunologically
mediated dermatosis? Br J Dermatol 1 977;96:343-7.
27. Verret JL, Pierrin B, Bertrand G, et al. Erythema gyratum repens:
011
syndrome paranéoplasique de Gammel. Ann Dermatol Venereol 1
977;104:403-6.
28. Barber PV, Doyle L, Vickers DM, et al. Erythema gyratum repens
with
pulmonary tuberculosis. Br J Dermatol 1978; 98:465-8.
29. Barriére H, Litoux P, Bureau B, et al. Erythema gyratum
repens de
Gammel et ichtyose acquise associés a un cancer de l'oesophage.
Ann
Dermatol Venereol 1978;105:3 19-21.
30. Jacobs R, Eng AM, Solomon LM. Carcinoma of the breast, pemphigus
vulgaris and gyrate erythema. mt J Dermatol 1978;17:221-4.
31. Stankler L. Erythema gyratum repens: spontaneous reso-lution in
a
healthy man (Lerter]. Br J Dermatol 1978;99: 461.
32. Tenailleau JP. Erythema gyratum repens [Lerter].
Ann Dermatol Vénéreol 1978;105:765.
33. ChristensenjD. Erythemagyratumrepens [Letter] .
Ugeskr Laeger 1979;141:3532.
34. Ressa PG, Colombo R. Erythema gyratum repens.
G Ital Dermatol Venereol 1980;115:301-2.
35. Breathnach SM, Wilkinson JD, Black MM. Erythema gy-ratum repens-like
figurate eruption in bulbus pemphigoid. Clin Exp Dermatol 1982;7:401-6.
36. Ingber A, Pullmann H, Nowel C. CRSET Syndrom: assoziation mit erythema
figuratum. Z Hautkr 1983;58:1298-306.
37. Larrouy JC, Apter J, Baréty M, et al. Erythema gyratum repens
et cancer bronchique primitif: disparition de la dermatose sous corticothérapie
gégérale. Ann Dermatol V~ néréol 1983;l
10:329-34.
38. Yebra SI, Garciá BB, Camacho MF. Eritema gyratum re-pens
de Gammel y
enfirmedad de Hodgkin. Med Cutan Ibero Lat Am 1983;11:281-6.
39. Olsen TG, Milroy SK, Jones-Olsen 5. Erythema gyratum repens with
associated squamous celí carcinoma of the lung. Cutis 1 984;34:35
1-5.
40. Cheesbrough MJ, Williamson DM. Erythema gyratum repens, a stage
in the
res~ution of pityriasis rubra pilaris? Clin Exp Dermatol 1985;l0:466-71.
41. Karalitski EM. Erythema gyratum repen~paraneoplas-ticheski dermatoz.
Vestn Dermatol Venereol 1985;8:49-51.
42. Langlois JC, Shaw JM, Odland GF. Erythema gyratum repens unassociated
with internal malignancy. J AM ACAD DERMATOL 1985;12:911-3.
43. Levine LE, Morgan NF, Fretzin D, et al. Erythema gyratum repens.
Arch Dermatol 1985;121:170-1.
44. Graham-Brown RAC. Bullous pemphigoid with figurate erythema associated
with carcinoma of the bronchus. Br J Dermatol 1987;l 17:385-8.
45. Appell ML, Ward WQ, Tyring SK. Erythema gyratum repens: a cutaneous
marker of malignancy. Cancer 1988; 62:548-50.
46. Juhlin L, Lacour LP, Larrouy JC, et al. Episodic erythema gyratum
repens witll ichthyosis and palmoplantar hyocrk-eratosis without sigus
of
internal malignancy. Clin Exp Dermatol 1 989;14:223-6.
47. Summerly R. The figurate erythemas and neoplasia.
Br J Dermatol 1964;76:370-3.
48. Burgdorf WRC, Goltz RW. Figurate erythemas. In: Fita-patnck TB,
Bisen
AZ, Wolff K, et al, eds. Dermatology in general medicine. New York:
McGraw-Hrn, 1987:1010-8.
49. White JW. Gyrate erythema.
Dermatol Clin 1985;3:l29-39.
50. Lever WF, Schaumburg-Lever G. Histopathology of the skin. Philadelphia:
JB Lippincott, 1983:137-8.
51. White JW. Hypersensitivity and miscellaneous inflammatory disorders.
In: Moschella SL, Hurley HJ, eds. Dermatology. Philadelphia: WB Saunders,
l985:46-98.
52. White JW, Perry HO. Erythema perstans.
Br J Dermatol 1969;81:641-5l.
53. Sheliey WB. Erythema annulare centrifugum.
Arch Der-matol 1 964;90:54-8.
54. Sniecinski 1, Haley J, Morgan-Byrne J, et al.Histocom-patibility-antigen
distribution in patients with cervical and endometrial carcinomas. Gynecol
Onool 1981; 11:68-74.
55. DeWolf WC, Lange PH, Binarson ME, et al. HLA and testicular cancer.
Nature 1 979;277:21 6-7.
56. Panza N, Del Veechio L, Maio M, et al. Strong association between
an
HLA-DR anfigen and thyroid carcinoma. Tissue Antigens 1982.20:155-8.
57. van den Tweel JG, Dugas DJ, Loon J, et al. HLA typing in non-Hodgkin's
lymphomas. Comparative study in caucasoids, Mexican-Americans and negroids.
Tissue Anti-gens 1 982;20:364-7 1.
58. Jones EH, Biggar RJ, Nkrumah FK, et al. Study of the HLA system
in
Burkitt's lymphoma. Hum Immunol 1980;3:207-l0.
59. Ludwig H, Mayr W. Genetic aspects of susceptibility to multiple
myeloma. Blood 1982;59:1286-91.
60. Gupta RK, Morton DL. Tumor antigeos. In: Ray PK, ed. Immunobiology
of
transpíantation, cancer and pregnancy.
New York: Pergamon Press, 1983:113-47.
61. Stone OJ. A mechanism of peripheral spread or localization of
inflammatory reactions-role of the localized ground substance adaptive
phenomenon. Med Hypotheses 1989; 29:167-9.
62. Moore HJ. Does the pattern of erythema gyratum repens depend on
a
reaction-dilfusion system? [Lerter] Br J Der-matol 1982;107:723.
63. Howel-Evans W, McConnell RB, Clarke DA, et al. Carci-noma of the
esophagus with keratosis palmaris et plantaris (tylosis). Q J Med
1958;27:413-29.
64. Richard M, Giroux J-M. Acrokeratosis paraneoplastic (Bazex syndrome).
JAM ACAD DERMATOL 1987;16:178-83.
65. Stone SP, Schrocter AL. Bulbus pemphigoid and associ-ated malignant
neoplasms. Arch Dermatol 1 975;1 11:991-4.
66. Kaplan RP, Callen JP. Pemphigus-associated diseases and induced
pemphigus. Clin Dermatol 1983; 1:42-71.
=============================================================
=============================================================
2.) Cutaneous manifestations of cancer.
=============================================================
Curr Opin Oncol 1999 Mar;11(2):139-44 Related Articles, Books
Sabir S, James WD, Schuchter LM
Hematology-Oncology Division, Hospital of the University of Pennsylvania,
Philadelphia 19104, USA.
The appearance of skin lesions in patients with occult or obvious
malignancy may be of extreme value in the detection and management
of
cancer because the skin is readily accessible to examination and biopsy.
Examination of the skin of our patients can provide important insights
into
underlying malignant processes or possible complications from cancer
treatment. The range of cutaneous abnormalities is wide, and include
cutaneous paraneoplastic syndromes such as xanthomas, acanthosis nigricans,
carcinoid syndrome, unusual erythematous eruptions such as erythema
gyratum
repens, and a number of genetic syndromes associated with malignancies
and
inherited dermatoses.
=============================================================
3.) Erythema gyratum repens in association with renal cell carcinoma.
=============================================================
J Urol 1998 Jun;159(6):2077 Related Articles, Books, LinkOut
Kwatra A, McDonald RE, Corriere JN Jr
Department of Surgery, University of Texas Medical School, Houston,
USA.
=============================================================
=============================================================
4.) Erythema gyratum repens: another case of a rare disorder but no
new insight into pathogenesis.
=============================================================
Dermatology 1996;193(4):336-7 Related Articles, Books
Rojo Sanchez S, Suarez Fernandez R, de Eusebio Murillo E, Lopez Bran
E,
Sanchez de Paz F, Robledo Aguilar A
Department of Dermatology, Hospital Universitario San Carlos, Madrid,
Spain.
Erythema gyratum repens (EGR) is an uncommon but distinctive dermatosis
characterized by marble-like swirls of erythema and a thin covering
scale
over the trunk, axillae and groins which has been associated with
malignancy. Bronchial carcinoma has been the most frequent neoplasm
associated. A case of EGR in a 50-year-old man with carcinoma of the
lung
is reported. The onset of dermatosis preceded the discovery of the
neoplasm
by 9 months. Oral corticosteroids induced the disappearance of the
skin
lesions. No recurrence was observed after discontinuation of the treatment.
The patient died 1 year after the onset of dermatosis.
=============================================================
5.) Cutaneous paraneoplastic syndromes in solid tumors.
=============================================================
Am J Med 1995 Dec;99(6):662-71 Related Articles, Books
Kurzrock R, Cohen PR
Department of Clinical Investigation, University of Texas M.D. Anderson
Cancer Center, Houston 77030, USA.
OBJECTIVE: To provide an overview of the clinical manifestations,
pathophysiology, and oncologic implications of the cutaneous paraneoplastic
syndromes that occur predominantly in patients with solid tumors. METHODS:
A review was performed of the literature identified by a comprehensive
MEDLINE search. RESULTS: Diverse cutaneous paraneoplastic syndromes
may be
associated with underlying tumors. They include musculoskeletal disorders
(clubbing, hypertrophic osteoarthropathy, dermatomyositis, and multicentric
reticulohistiocytosis), reactive erythemas (erythema gyratum repens
and
necrolytic migratory erythema), vascular dermatoses (Trousseau's syndrome),
papulosquamous disorders (acanthosis nigricans, tripe palms, palmar
hyperkeratosis, acquired ichthyosis, pityriasis rotunda, Bazex's syndrome,
florid cutaneous papillomatosis, the sign of Leser-Trelat, and extramammary
Paget's disease), and disorders of hair growth (hypertrichosis lanuginosa
acquisita). The clinical manifestations of these dermatoses may precede,
coincide with, or follow the diagnosis of cancer. The presence of a
cutaneous paraneoplastic syndrome is often associated with a poor
prognosis. CONCLUSIONS: Cutaneous paraneoplastic syndromes are specific
constellations of mucous membrane and/or skin abnormalities that are
caused
by an underlying tumor. Since they may be the presenting sign of an
occult
cancer, cognizance of their features and clinical implications are
of
considerable importance. Individuals with these syndromes should have
a
thorough workup for an associated malignancy.
=============================================================
6.) Erythema gyratum repens unassociated with underlying malignancy.
=============================================================
J Dermatol 1995 Aug;22(8):587-9 Related Articles, Books
Kawakami T, Saito R
Second Department of Dermatology, Toho University School of Medicine,
Tokyo, Japan.
A case of erythema gyratum repens occurring in a 62-year-old woman is
presented together with a review of the literature. Evaluation and
follow-up for the development of malignancy over a 32-month period
failed
to reveal any evidence of malignancy. Formerly, all cases of erythema
gyratum repens were evaluated in terms of an association with an underlying
malignant disorder. To date, only sixty cases have been reported in
the
literature; 14 (23%) were not found to be associated with any neoplasm.
Therefore, this term is now also used for cases unassociated with
malignancy. Erythema gyratum repens is a cutaneous eruption with a
characteristic diagnostic morphology resembling a wood grain pattern.
=============================================================
7.) Erythema gyratum repens-like eruption in a patient with Sjogren
syndrome.
=============================================================
Acta Derm Venereol 1995 Jul;75(4):327 Related Articles, Books
Matsumura T, Kumakiri M, Sato-Matsumura KC, Ohkawara A
Publication Types:
Letter
=============================================================
=============================================================
8.) Paraneoplastic bullous pemphigoid resembling erythema gyratum repens.
Br J Dermatol 1999 Mar;140(3):550-2 Related Articles, Books, LinkOut
=============================================================
Hauschild A, Swensson O, Christophers E
Publication Types:
Letter
=============================================================
=============================================================
9.) Eruption resembling erythema gyratum repens in linear IgA dermatosis.
=============================================================
Dermatology 1995;190(3):235-7 Related Articles, Books
Caputo R, Bencini PL, Vigo GP, Berti E, Veraldi S
Istituto di Scienze Dermatologiche, Universita di Milano, Ospedale
Policlinico IRCCS, Italia.
We report a case of linear IgA dermatosis associated with eruptions
resembling erythema gyratum repens in a 62-year-old man. The patient
revealed no clinical and laboratory evidence of an underlying malignancy.
The presence of eruptions similar to erythema gyratum repens during
the
course of bullous dermatoses has been described in only eight reports.
=============================================================
10.) Erythema gyratum repens associated with hypereosinophilic syndrome.
=============================================================
J Dermatol 1994 Aug;21(8):612-4 Related Articles, Books
Morita A, Sakakibara N, Tsuji T
Department of Dermatology, Nagoya City University Medical School, Japan.
We report a case of typical erythema gyratum repens lesions observed
as a
manifestation of idiopathic hypereosinophilic syndrome in a 63-year-old
man. While erythema gyratum repens is usually associated with malignancy,
an intensive search over a 30-month period failed to reveal any evidence
of
neoplasm. With administration of dapsone, the typical gyrate lesions
disappeared as the subject's hypereosinophilia improved.
=============================================================
11.) Erythema gyratum repens. A case studied with immunofluorescence,
immunoelectron microscopy and immunohistochemistry.
=============================================================
Br J Dermatol 1994 Jul;131(1):102-7 Related Articles, Books
Caux F, Lebbe C, Thomine E, Benyahia B, Flageul B, Joly P, Rybojad M,
Morel P
Service de Dermatologie, Hopital Saint-Louis, Paris, France.
We report a patient with erythema gyratum repens (EGR), in whom a bronchial
carcinoma was found. Direct immunofluorescence revealed granular deposits
of immunoglobulins at the basement membrane zone (BMZ) in the skin,
and in
the lung tumour. Direct immunoelectron microscopy showed that the immune
deposits were localized just beneath the lamina densa. Indirect
immunofluorescence revealed circulating anti-BMZ antibodies.
Immunohistochemical staining, using anti-transforming growth factor-beta,
anti-epidermal growth factor receptor, anti-vimentin and anti-alpha-actin,
was found to be more intense in the lesional skin and the lung tumour
than
in normal tissues. Possible mechanisms in the pathogenesis of EGR are
discussed.
=============================================================
12.) Erythema gyratum repens: direct immunofluorescence microscopic
findings.
=============================================================
J Am Acad Dermatol 1993 Sep;29(3):493-4 Related Articles, Books,
LinkOut
Albers SE, Fenske NA, Glass LF
Department of Internal Medicine, University of South Florida, College
of
Medicine.
=============================================================
=============================================================
13.) Erythema gyratum repens without underlying disease.
=============================================================
J Am Acad Dermatol 1993 Jan;28(1):132 Related Articles, Books, LinkOut
Boyd AS, Neldner KH
Publication Types:
Comment
Letter
=============================================================
=============================================================
14.)Reactive erythemas: erythema annulare centrifugum and erythema
gyratum
repens.
=============================================================
Clin Dermatol 1993 Jan-Mar;11(1):135-9 Related Articles, Books
Tyring SK
Department of Dermatology, University of Texas Medical Branch, Galveston.
Publication Types:
Review
Review, tutorial
=============================================================
=============================================================
15.) Subcorneal accumulation of Langerhans cells in erythema gyratum
repens.
=============================================================
Br J Dermatol 1992 Feb;126(2):189-92 Related Articles, Books
Wakeel RA, Ormerod AD, Sewell HF, White MI
Department of Dermatology, Aberdeen Royal Infirmary, U.K.
Erythema gyratum repens (EGR) is a cutaneous manifestation of malignant
disease. We report an unusual accumulation of activated epidermal
Langerhans cells in the upper layer of the epidermis and propose that
these
cells play an important immunopathological role.
=============================================================
16.) Erythema gyratum repens in a healthy woman.
=============================================================
J Am Acad Dermatol 1992 Jan;26(1):121-2 Related Articles, Books
Garrett SJ, Roenigk HH Jr
Department of Dermatology, Northwestern University Medical School, Chicago,
IL 60611.
Comments:
Comment in: J Am Acad Dermatol 1993 Jan;28(1):132
=============================================================
=============================================================
17.)[Gammel's non-paraneoplastic erythema gyratum repens].
=============================================================
Ann Dermatol Venereol 1991;118(6-7):469 Related Articles, Books
[Article in French]
Bazex J, Marguery MC
Service de Dermatologie, Allergologie et Venereologie, Hopital Purpan,
Toulouse.
Publication Types:
Review
Review of reported cases
=============================================================
=============================================================
18.) [Erythema gyratum repens type eruption].
=============================================================
Ann Dermatol Venereol 1991;118(11):897-9 Related Articles, Books
Goettmann S, Lazareth I, Crickx B, Lemaire V, Belaich S
Service de Dermatologie, Hopital Bichat, Paris.
=============================================================
=============================================================
19.) A mechanism of peripheral spread or localization of inflammatory
reactions--role of the localized ground substance adaptive phenomenon.
=============================================================
Med Hypotheses 1989 Jul;29(3):167-9 Related Articles, Books
Stone OJ
It is known that connective tissue-active peptides (CTAP) are released
at
sites of inflammation. Some of this material diffuses to immediately
adjacent tissue and increases ground substance viscosity and fibroblast
proliferation. This contributes to host protection against spread of
infections and tumors. In a person with normal inflammatory reactivity,
it
should prevent spread of mediators and products of local inflammation.
However, the host with an increased reactivity in sites of increased
ground
substance viscosity or who is highly reactive to dilution of tissue
fluid
would respond with more inflammation. A non-infectious, non-malignant
process in a host with a highly reactive inflammatory or immune response
could end up with peripheral spread. This could occur in any tissue
but it
occurs with great vigor in the skin. It could present as a peripheral
extension of a local disease process, such as psoriasis, or the migration
of cyclic lesions with clearing of the central area. There are over
a dozen
variants of peripherally spreading, ringed lesions described in the
dermatologic literature. This includes erythema marginatum of rheumatic
fever, erythema gyratum repens associated with cancer, and erythema
annulare centrificum associated with allergic reactions to fungi. Many
of
the ringed dermatologic lesions have an immunologic component. They
tend to
be associated with inflammatory immune reactions at distant sites.
Dermatologists have been gathering information on the ringed phenomenon
at
least since Hebra in 1854. The acute localized ground substance adaptive
phenomenon is a broadly beneficial biologic response.
=============================================================
20.) Episodic erythema gyratum repens with ichthyosis and palmoplantar
hyperkeratosis without signs of internal malignancy.
=============================================================
Clin Exp Dermatol 1989 May;14(3):223-6 Related Articles, Books
Juhlin L, Lacour JP, Larrouy JC, Baze PE, Ortonne JP
Two patients with typical lesions of erythema gyratum repens, peripheral
ichthyosis, palmoplantar hyperkeratosis and nail changes are described.
A
non-specific erythrodermic eruption of several weeks' duration had
preceded
the typical lesions. No signs of internal malignancy were found and
the
typical gyrate lesions disappeared within some weeks with full restitution
of all skin lesions within 6-8 months.
=============================================================
21.) Erythema gyratum repens. A cutaneous marker of malignancy.
=============================================================
Cancer 1988 Aug 1;62(3):548-50 Related Articles, Books
Appell ML, Ward WQ, Tyring SK
Department of Dermatology, University of Alabama, Birmingham.
A patient with erythema gyratum repens in whom a bronchogenic carcinoma
was
found is described. Erythema gyratum repens is a cutaneous eruption
with a
unique morphology resembling a wood grain pattern. Its presence is
almost
always associated with serious systemic pathology, usually neoplastic,
and
thus should be considered a cutaneous marker of internal malignancy.
=============================================================
22.) Bullous pemphigoid with figurate erythema associated with carcinoma
of the bronchus.
=============================================================
Br J Dermatol 1987 Sep;117(3):385-8 Related Articles, Books
Graham-Brown RA
Department of Dermatology, Leicester Royal Infirmary, Infirmary Square,
U.K.
A patient with bullous pemphigoid (BP), a figurate erythema resembling
erythema gyratum repens and a bronchial carcinoma is reported. It is
suggested that this is a genuine association and that when a figurate
erythema occurs with BP, an underlying carcinoma should be excluded.
=============================================================
23.) Erythema figuratum versus erythema gyratum repens.
=============================================================
J Am Acad Dermatol 1986 Jul;15(1):111-2 Related Articles, Books
Ingber A, Sandbank M
Publication Types:
Letter
=============================================================
=============================================================
24.) Erythema gyratum repens, a stage in the resolution of pityriasis
rubra
pilaris?
=============================================================
Clin Exp Dermatol 1985 Sep;10(5):466-71 Related Articles, Books
Cheesbrough MJ, Williamson DM
=============================================================
=============================================================
25.)[Erythema gyratum repens--a paraneoplastic dermatosis].
=============================================================
Vestn Dermatol Venerol 1985 Aug;(8):49-51 Related Articles, Books
[Article in Russian]
Karalitskii EM
=============================================================
=============================================================
26.)Erythema gyratum repens unassociated with internal malignancy.
=============================================================
J Am Acad Dermatol 1985 May;12(5 Pt 2):911-3 Related Articles, Books
Langlois JC, Shaw JM, Odland GF
A case report of erythema gyratum repens occurring in a 68-year-old
man is
presented. Evaluation and follow-up for development of malignancy over
a
39-month period failed to reveal evidence of malignancy. The patient
died
of an unrelated cause. Autopsy did not demonstrate any evidence of
malignancy.
=============================================================
27.) Erythema gyratum repens.
=============================================================
Arch Dermatol 1985 Feb;121(2):170-1 Related Articles, Books
Levine LE, Morgan NE, Fretzin D, Rubenstein D
Publication Types:
Letter
=============================================================
=============================================================
28.) Gyrate erythema.
=============================================================
Dermatol Clin 1985 Jan;3(1):129-39 Related Articles, Books
White JW Jr
The gyrate erythemas consist of a nonspecific group (often called erythema
annulare centrifugum) for which the cause is usually unknown, and three
specific types (erythema marginatum rheumaticum, erythema chronicum
migrans
[Lyme disease], and erythema gyratum repens). The first specific type,
erythema marginatum rheumaticum, has become extremely rare with the
decline
of its associated disease, rheumatic fever. The second specific type,
erythema chronicum migrans, is caused by a spirochete transmitted by
the I.
ricinus complex of ticks. The third specific type, erythema gyratum
repens,
is uncommon, morphologically distinctive, and an indicator of serious
disease, usually internal malignancy, in almost every instance.
=============================================================
29.) Infantile epidermodysplastic erythema gyratum responsive to imidazoles.
A new entity?
=============================================================
Arch Dermatol 1984 Dec;120(12):1601-3 Related Articles, Books
Saurat JH, Janin-Mercier A
A 3 1/2-year-old girl had a three-year history of chronic annular erythema
that more closely mimicked erythema gyratum repens of adults than other
annular erythemas of infancy. Histopathologic study revealed bowenoid
characteristics in the epidermis. No fungi were ever demonstrated in
this
patient's skin lesions, but they consistently responded to treatment
with
ketoconazole and flared immediately after cessation of treatment with
that
drug.
=============================================================
30.) Erythema gyratum repens with associated squamous cell carcinoma
of the lung.
=============================================================
Cutis 1984 Oct;34(4):351-3, 355 Related Articles, Books
Olsen TG, Milroy SK, Jones-Olsen S
A 63-year-old man with erythema gyratum repens (EGR) was found to have
an
underlying squamous cell carcinoma of the lung. Neither radiation nor
chemotherapy had any effect on the extensive eruption. EGR is the most
distinctive of the figurate erythemas, and continues to be one of the
most
consistent cutaneous signs of an associated visceral malignancy.
=============================================================
31.) [Cutaneous paraneoplastic syndromes].
=============================================================
Ann Med Interne (Paris) 1984;135(8):662-8 Related Articles, Books
Barriere H
The authors list the really significant paraneoplastic cutaneous syndromes:
acanthosis nigricans, paraneoplastic acrokeratosis, acquired ichthyosis
(and eventually the "explosive" onset of seborrheic warts) and a special
type of desquamative circinate erythema (erythema gyratum repens).
The
possible paraneoplastic character of other conditions is also discussed:
dermatomyositis, necrosing vasculitis, autoimmune bullous conditions
and
pruritus "sine materia".
=============================================================
32.) [Erythema gyratum repens and primary bronchial cancer. Disappearance
of the dermatosis under general corticoid therapy].
=============================================================
Ann Dermatol Venereol 1983;110(4):329-34 Related Articles, Books
[Article in French]
Larrouy JC, Apter J, Barety M, Ortonne JP
A case of Erythema Gyratum Repens in a 76 year old man with bronchiolar
carcinoma is reported. The onset of the dermatosis preceded the discovery
of the neoplasm. Oral corticosteroids induced the disappearance of
the skin
lesions. No recurrence was observed after discontinuation of the treatment.
The patient died 7 months after the onset of the dermatosis.
=============================================================
33.) [Erythema gyratum repens of Gammel and Hodgkin's disease].
=============================================================
Med Cutan Ibero Lat Am 1983;11(4):281-6 Related Articles, Books
[Article in Spanish]
Yebra Sotillo I, Garcia Bravo B, Camacho Martinez F
A 65 year old male with Hodgkins disease, and generalised figurate
Erythema, which during his period of hospitalisation migrated and became
much more evident, disappearing after initial therapy. Diagnosed as
"Erythema gyratum repens" reported by Gammel, an uncommon form of
paraneoplasic migrant figurate Erythema, we review the 33 previous
cases of
this process, and find that, although 30 were related to other processes.
=============================================================
34.) Erythema gyratum repens-like figurate eruption in bullous pemphigoid.
=============================================================
Clin Exp Dermatol 1982 Jul;7(4):401-6 Related Articles, Books
Breathnach SM, Wilkinson JD, Black MM
=============================================================
=============================================================
35.) [Erythema gyratum repens].
=============================================================
Ugeskr Laeger 1979 Dec 17;141(51):3532 Related Articles, Books
[Article in Danish]
Christensen JD
=============================================================
=============================================================
36.) [Erythema gyratum repens].
=============================================================
Hautarzt 1979 Apr;30(4):213-5 Related Articles, Books
[Article in German]
Verret JL, Schnitzler L, Schubert B, Alain YM, Bertrand G
A case of erythema gyratum repens is reported in 78 year old woman.
The
particularly typical eruption, mainly affecting the trunk, was associated
with a squamous cell carcinoma of the esophagus. The paraneoplastic
dermatosis cleared after radiotherapy of the cancer.
=============================================================
37.) Erythema gyratum repens: spontaneous resolution in a healthy man.
=============================================================
Br J Dermatol 1978 Oct;99(4):461 Related Articles, Books
Stankler L
Publication Types:
Letter
=============================================================
=============================================================
38.) Erythema gyratum repens with pulmonary tuberculosis.
=============================================================
Br J Dermatol 1978 Apr;98(4):465-8 Related Articles, Books
Barber PV, Doyle L, Vickers DM, Hubbard H
A 63-year-old man presented with erythema gyratum repens of 7 months'
duration. A cavitating mass at the right lung apex was resected and
proved
to be tuberculous. Following the resection, the skin lesions cleared
within
a few days. Erythema gyratum repens has not previously been described
in
association with non-malignant visceral pathology. The pathogenesis
remains
obscure but cannot be related specifically to a response to tumour
cells or
their products in view of the association reported here. The condition
bears no resemblance to any known tuberculide.
=============================================================
39.) [Gammel's erythema gyratum repens and acquired ichthyosis associated
with esophageal carcinoma].
=============================================================
Ann Dermatol Venereol 1978 Mar;105(3):319-21 Related Articles, Books
Barriere H, Litoux P, Bureau B, Preel JL, Thebaud Y
=============================================================
=============================================================
40.) [Erythema gyratum repens or Gammel paraneoplastic syndrome. A
case with
epidermoid carcinoma developed on a megaesophagus].
=============================================================
Ann Dermatol Venereol 1977 May;104(5):403-6 Related Articles,
Books
[Article in French]
Verret JL, Pierrin B, Bertrand G, Dubin J, Allain YM, Schnitzler L
=============================================================
=============================================================
41.) Erythema gyratum repens--an immunologically mediated dermatosis?
=============================================================
Br J Dermatol 1977 Apr;96(4):343-7 Related Articles, Books
Holt PJ, Davies MG
=============================================================
=============================================================
42.) Erythema gyratum repens with metastatic adenocarcinoma.
=============================================================
Arch Dermatol 1975 Feb;111(2):227-9 Related Articles, Books
Skolnick M, Mainman ER
A patient with Erythema Gyratum Repens (EGR) had a marked increase of
his
eruption, with uncontrollable pruritus that was unresponsive to steriod
therapy. This culminated in an exfoliative dermatitis. A metastatic,
undifferentiated adenocarcinoma was removed following a right-sided
craniotomy. The patient then had complete cessation of his pruritus,
with
moderate improvement of his eruption. All the reported cases of EGR
were
reviewed in terms of the source of the malignant disorder. The relationship
between the time of onset of the EGR and the discovery of the malignant
disorder, as well as the effect of treatment of the malignant condition
on
the course of the EGR, was studied. The data suggest a highly probable
relationship between the two.
=============================================================
43.) [Erythema gyratum repens (Gammel's syndrome)]
=============================================================
SO - Hautarzt 1979 Apr;30(4):213-5
AU - Verret JL; Schnitzler L; Schubert B; Alain YM; Bertrand
G
PT - JOURNAL ARTICLE
AB - A case of erythema gyratum repens is reported in 78 year
old woman.
The particularly typical eruption, mainly affecting the trunk, was
associated with a squamous cell carcinoma of the esophagus. The
paraneoplastic dermatosis cleared after radiotherapy of the cancer.
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44.) Figurate and bullous eruption in association with breast carcinoma.
=============================================================
SO - Arch Dermatol 1990 May;126(5):649-52
AU - Watsky KL; Orlow SJ; Bolognia JL
PT - JOURNAL ARTICLE; REVIEW (16 references); REVIEW OF REPORTED
CASES
AB - We describe a patient with two coexistent cutaneous eruptions:
(1)
trauma-induced bullae of the distal extremities and elbows and (2)
multiple
concentric gyrate lesions on the trunk and extremities, some of which
became bullous. The gyrate lesions were stationary and nonpruritic.
Biopsy
of both types of lesions showed a subepidermal blister and a minimal
inflammatory infiltrate. Direct immunofluorescence revealed linear
deposition of IgG and C3 at the dermoepidermal junction and indirect
immunofluorescence was negative. By immunoelectron microscopy, these
immune
deposits were localized to the lower lamina lucida. The eruption was
not
controlled despite high-dose (80 mg/d) oral administration of prednisone
and required the addition of an oral administration of methotrexate
(20 mg
weekly). On further evaluation, an intraductal mammary carcinoma was
detected. Following radiation therapy, the methotrexate and prednisone
therapy were tapered without recurrence of the eruption during a follow-up
period of 18 months.
=============================================================
45.) [Erythema gyratum repens associated with bronchial carcinoma]
=============================================================
SO - Hautarzt 1970 Mar;21(3):116-9
AU - Hochleitner H; Bartsch G; Zelger J
PT - JOURNAL ARTICLE
=============================================================
=============================================================
46.) Erythema gyratum repens. Reports of two further cases associated
with
carcinoma.
=============================================================
SO - Br J Dermatol 1970 Apr;82(4):406-11
AU - Thomson J; Stankler L
PT - JOURNAL ARTICLE
=============================================================
=============================================================
47.) Carcinoma of the breast, pemphigus vulgaris and gyrate erythema.
=============================================================
SO - Int J Dermatol 1978 Apr;17(3):221-4
AU - Jacobs R; Eng AM; Solomon LM
PT - JOURNAL ARTICLE
=============================================================
=============================================================
48.) [Premycotic erythema simulating erythema gyratum repens].
=============================================================
Bull Soc Fr Dermatol Syphiligr 1969;76(1):12 Related Articles, Books
[Article in French]
Duperrat B, Puissant A, Cherif-Cheikh JL, Pringuet R, David V, Blanchet
P
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=============================================================
=============================================================
49.) An unusual paraneoplastic syndrome: erythema "gyratum repens"
or Gammel's syndrome].
=============================================================
Presse Med 1967 May 20;75(24):1239-42 Related Articles, Books
[Article in French]
Migueres J, Jover A, Layssol M, Ranfaing J
=============================================================
=============================================================
50.) [An unusual paraneoplastic syndrome: erythema gyratum repens.
Its relation with bronchial cancer].
=============================================================
J Fr Med Chir Thorac 1967 Apr;21(3):313-24 Related Articles, Books
[Article in French]
Migueres J, Jover A, Layssol M, Ranfaing J
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DERMAGIC/EXPRESS 2-(93) 19 Abril 2.000 19 April 2.000 DR. JOSE
LAPENTA R.
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