Erythema marginatum is an uncommon skin condition marked by formation of a distinctive rash; pinkish rings in the inner parts of extremities, the trunk, and the upper body; and is linked with rheumatic fever. It is not a condition in itself, but rather a symptom of some other underlying illness. It can also be triggered by a variety of factors, including allergic reactions and/or infection.
Males and children are mostly affected by erythema marginatum as compared to adults; but the rash can occur in people of all age groups and both genders. The rash does not cause itchiness or pain and often resolves on its own. It can however keep recurring over a period of many months.
Erythema marginatum is not a severe condition and does not require medical treatment. Patients however need to visit a doctor to diagnose the underlying causative condition and then get treatment for it.
Symptoms of erythema marginatum
Some of the common signs and symptoms of erythema marginatum are listed below:
- Formation of macular circular structures or rings with a discolored center. The margins of the macular are irregular; this is due to the slow formation of the macular rings.
- The rings are reddish or pinkish in color and the center is clear or pale
- The lesion or rash tends to be raised while the core of the macular rings is small and flatter.
- The size of the macular rings range between 0.4 cm and 8.1 cm diametrically. Over a period of time, the size of the rings increase and spread; this causes the shape and borders of the rash to become irregular.
- People with erythema marginatum do not feel any itchiness, discomfort, pain, or burning sensations.
- The lesion typically forms on the inside part of extremities and on the lower section of the torso in the initial stages. The rash on trunk will then vanish and spread upward towards the upper body where it becomes more noticeable. The outward sections of the extremities and the face normally do not develop the rash.
- Hot showers, exposure to very hot climates, and contact with other heat sources can aggravate the erythema marginatum lesions. The exacerbated rash appears reddish but will become lighter once again at room temperature.
Types
As per the initial location of the rash and its features, erythema marginatum can be classified into two types as discussed below:
- Erythema marginatum perstans: In this type, the rash is spread across the skin surface of the legs and the arms. It may also spread to other parts of the body with the exception of the soles of feet and the palms of hands. This type of erythema marginatum rash can also affect the deeper skin layer. Erythema marginatum perstans is often caused due to an underlying disease.
- Erythema marginatum rheumaticum: In this type, the rash affects the superficial skin layer. It usually does not cause any symptoms. The lesions normally occur on the skin surface of inner sections of limbs and the torso. Erythema marginatum rheumaticum is related to rheumatic fever. This type is considered to a form of gyrate erythema. Doctors are not aware of its exact cause.
Causes of erythema marginatum
It is postulated that erythema marginatum develops due to blood vessels inflammation which may be activated by the lymphocytes histiocytes. Medical experts are currently not aware of the manner in which the epidermal skin layer changes to result in formation of erythema marginatum. Hence, the exact cause of the skin condition is not known.
Even though the exact cause of erythema marginatum has not been identified as yet, there are many factors that can increase the risk to development of the skin rash. They are listed below:
- Rheumatic fever is an illness which is most linked with cases of erythema marginatum in patients. The fever is caused due to infection by bacteria, especially of Group A streptococcus. Formation of the rash is regarded as a medical complication of the illness.
- Infection by different types of infectious agents can lead to formation of rash. Two infectious agents that are known to trigger development of erythema marginatum are Escherichia coli and Candida albicans.
- Allergic reaction to different kinds of substances, etc. can cause inflammation of blood vessels which in turn can trigger the formation of erythema marginatum lesions.
- Erythema marginatum rashes may occur as an adverse side effect of certain medicines.
- One of the symptoms of Lyme disease is erythema marginatum rashes. Lyme disease is a bacterial infection caused by Borrelia burgdorferi pathogen. The bacteria transfer to humans via bite of ticks that carry the pathogen.
- Leukemia, breast cancer, and/or other malignancies or severe diseases may trigger formation of the rashes.
Treatment of erythema marginatum
Erythema marginatum is not a disease but rather a symptom of some other underlying condition.
Hence, treatment of erythema marginatum is dependent on diagnosing the underlying causative ailment and then treating it as per set medical procedures.
