Erythema Marginatum - Causes, Symptoms, Treatment
What Is Erythema Marginatum?
Erythema Marginatum is a skin disorder in which the patient develops a skin rash with clear margins which are elevated. These rashes have clear center. This rash is quite serious as may result in development of rheumatic fever. It is a type of annular erythema. These types of rashes are usually seen on the trunk and proximal part of the extremities. In majority of the cases, the face and the soles of the feet are spared from this type of rash. These rashes do not itch and are never painful and hence many people may not even pay attention to it.
What Is The Classification Of Erythema Marginatum?
Erythema Marginatum is not a disease condition but is rather a symptom of a medical condition which resulted in development of the rash. There are two types of Erythema Marginatum which are:
Erythema Marginatum Rheumaticum: This type of rash is asymptomatic and superficial in nature. It is normally associated with rheumatic fever and has no known cause to it. These rashes are seen scattered all around the trunk and the proximal part of the limbs.
Erythema Marginatum Perstans: In this type of Erythema Marginatum, the rash is usually seen in the feet and the arms. The rashes can also spread to other areas of the body except the palms of the hands and soles of the feet which are more often than not spared from these rashes. These types of rashes are usually caused due to some underlying medical condition.
Erythema Marginatum is normally seen in people who are fair skinned than people who are dark in complexion. Erythema Marginatum can occur at any age and is seen to occur in males more than females.
What Causes Erythema Marginatum?
Majority of the cases of Erythema Marginatum are caused due to an underlying medical condition but in some cases these rashes do not have known cause to it. The red areas are formed due to inflammation of blood vessels resulting due to accumulation of WBCs. As a result of the inflammation, there is development of a rash. Rheumatic fever is the most common cause of Erythema Marginatum and it is one of the presenting features of rheumatic fever. Heat may also be a factor in development of Erythema Marginatum. This is why the rashes normally occurs a couple of weeks after development of fever. They are first seen on the trunk and then they spread to other parts of the body except the palms and the soles of the foot. These rashes may last for a few months but in some cases they may last for over a year. It is a recurrent condition and it comes and goes on its own. Some of the other causes of Erythema Marginatum are:
- Lyme disease
- Allergy to tomatoes
- Bacterial infections
- Medications like penicillin
- Malignant conditions like leukemia or breast cancer
What Are The Symptoms Of Erythema Marginatum?
The classic presenting feature of Erythema Marginatum is a red rash with elevated regular margines and clear and small center. This rash tends to start in the trunk areas and then spread to other parts of the body. Normally, the palms of the hands and soles of the feet are spared from these rashes. The size of the rashes may vary and range from 0.5 cm to 1 cm in diameter. These rashes do not cause and pain and they do not itch hence not much attention is paid to these rashes until they start spreading all over the body. The rash may start to develop a couple of weeks after onset of fever. It may also occur in extremely hot weather conditions and may disappear when the weather turns cool.
How Is Erythema Marginatum Treated?
Since Erythema Marginatum is not a disease condition but actually a symptom of an underlying condition hence treatment should be directed towards the cause of the rash. Once the cause of the rash is treated the rash disappears on its own with time and no specific treatment for the rash is required. Since rheumatic fever is the most common cause of Erythema Marginatum hence treatment will focus on eliminating the bacteria causing it and the patient will have to undergo a course of antibiotic treatment for at least a period of six weeks and once rheumatic fever is treated the rash starts to disappear.
Any medication which may tend to aggravate the rash or increase heat in the body needs to be changed. It is also important to stay away from foods which may increase heat in the body while having Erythema Marginatum as it may worsen the rashes. Also, if an individual is allergic to certain medications or food it is important to stay away from such foods and medications in order to prevent or worsen Erythema Marginatum.