Erythema Elevatum Diutinum (EED)

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Erythema elevatum diutinum (EED) is a rare and usually chronic form of vasculitis. It has been postulated that EED is the result of immune complex formation in small vessels secondary to some antigenic stimulation.

Erythema elevatum diutinum (EED) is a rare and usually chronic form of vasculitis. It has been postulated that EED is the result of immune complex formation in small vessels secondary to some antigenic stimulation.

EED is characterized clinically by papular lesions, as shown in the figure; these may be very small originally, but later can become larger and annular.1 They are located juxta-articularly on the extensor surfaces of the dorsum of the hands, knuckles, elbows, dorsum of the feet, knees, and buttocks. Initially, lesions are red to purple; later, they may become brown, yellow, or flesh-colored.

Options for treatment include dapsone, sulfapyridine, combinations of tetracycline and niacinamide,4 and oral and topical corticosteroids.