Deep variant of Erythema Annulare Centrifugum

A 29-year-old woman came to our outpatient clinic with a several-month history of itchy red lesions over her trunk. There was no family history and past history of any other diseases or medication. Dermatological examination revealed annular and oval-shaped plaques up to several cm’s in size, one of which was polycyclic in configuration, on back of the patient (Fig. 1). It was also noticed that lesions had erythematous indurated bordes with paler central areas (Fig. 1). In addition there was an erythematous, firm, solitary papule with prominent pallor on the centrum of one of the large plaques which was situated on the right posterior thoracic area (Fig. 2). A lesional skin biopsy demonstrated superficial and deep perivascular ‘sleeve-like’ lymphohistiocytic infiltrate (Figs 3, 4). Laboratory investigations including complete blood count and differential, erythrocyte sedimentation rate, serum chemistry profile, urinalysis, thyroid panel, chest X-ray, antinuclear antibodies, antibodies against borrelia, cultures for fungi, purified protein derivative test, screening for anti-HIV were within normal limits and malignancy workup was negative. DEEP VARIANT OF ERYTHEMA ANNULARE CENTRIFUGUM