Acral Erythema

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Acral Erythema Prep . By Dr. Bassem Mohammed Bashandy MSc; dermatology

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What is the difference? What is inside?

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Painless erythema of the hands associated with non-Hodgkin’slymphoma in a lung transplant recipient This phenomenon suggested the erythema was a hitherto undescribed paraneoplastic manifestation during immunosuppression after lung transplantation.

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Papulo-Purpuric Gloves and Socks Syndrome ( PPGSS ) duo to parvovirus B19 infection Progressive, symmetric, painful and pruritic swelling and erythema of the distal extremities. Confluent papular or petechiael/purpuric lesions develop on the palms and soles. Subsequently, many patients develop an exnanthem.

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Methotrexate-Induced Acral Erythema with Bullous Reaction Chemotherapy-induced acral erythema (CIAE), is a cutaneous drug reaction that is most often induced by cytarabine, fluorouracil, and doxorubicin. The reaction is dose dependent, and may appear with bolus short-term infusions or low-dose, long-term infusions.

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Chemotherapy–Induced Acral Erythema, Kansas Journal of Medicine 2007 A 79-year-old woman was diagnosed with MF, received vincristine and cytoxan chemotherapy. She presented with erythema, desquamation of both hands, and very stiff underlying dermis.

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Palmar erythema and hoarseness: an unusual clinical presentation of sarcoidosis Palmar erythema is a very unusual skin manifestation of sarcoidosis — it has been reported only once before in the literature.

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A 46–year–old Egyptian man presented with a 3 – days history of painful erythema an blisters of both hand and feet ( gloves and socks distribution) after ingestion of ?? Antibiotic.

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Necrolytic acral erythema This adolescent boy with a history of HCV infection developed a pruritic eruption on his face, trunk, genitals, and extremities with a predilection for bony prominences. Failed to respond to multiple topical therapies including topical steroids, antihistamines, topical barrier repair creams, NB-UVB and tar baths. Symmetric acral thick confluent hyperpigmented and crusted papules and plaques

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He was also given oral zinc for borderline low serum zinc levels. A skin biopsy showed a nonspecific psoriasiform dermatitis consistent with necrolytic acral erythema. Hepatitis C virus RNA PCR studies showed 974,000 IU/mL (<50) and HCV RNA genotype 1b. Symmetric acral thick confluent hyperpigmented and crusted papules and plaques

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Erythema palmare hereditarium (Lane’s redpalms): A forgotten entity?, J AM ACAD DERMATOL, AUGUST 2010. Erythema palmare hereditarium is a benign condition that was first described by Lane1 in 1929 in two patients with a similar family history. Erythema presents usually at birth and remains stable throughout life. Histology shows dilated vessels in the entire dermis with no inflammatory infiltrate. Fig 1. Bilateral palmar erythema with scattered purplish telangiectasias.

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Acral erythema/ Differential diagnosis: Collagen disorders; LE, DM, and scleroderma, typically limited to the proximal nailfold with telangiectasia. Chemotherapy-induced (CIAE); such as 5-fluorouracil, doxorubicin, or cytosine arabinoside. With acute graft-versus-host disease; typically accompanied by blistering, scaling, and pain.

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Erythromelalgia(Erythermalgia) episodic attacks of burning pain in the distal extremities , which last for minutes to days. precipitated by exercise, warmth, or limb dependency. associated with erythema , warmth, and swelling of the involved part. There are a primary or idiopathic form and a secondary form that occur with myeloproliferative or other diseases.

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Red fingers syndrome ( in association with HIV or hepatitis C infection ). Papular-purpuric gloves-and-socks syndrome. As a paraneoplastic singe. Contact dermatitis. Hyperthyroidism and liver diseases, and may occasionally occur in RA, sarcoidosis, ….

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Pregnancy; Isolated palmar erythema is commonly seen in pregnancy (affecting at least 70% of white women and 30% of black women) Sustained high levels of circulating estrogen. In some , it takes the form of a diffuse , pink mottling of the while palm whereas in others the changes are confined to the thenar and hypothenar eminence.

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ACRAL ERYTHEMA

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Difrential diagnosis of acral erythema
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