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“The Erythemas” – A #dermatology #meded #FOAMEd #tweetorial. pc:@dermnetnz
Ever get all the different #dermatologic terms jumbled up? Was it erythema nodosum, erythema migrans, or erythema multiforme?
Honest poll – Ever write “rash” b/c you couldn’t remember the diagnosis?
“The Erythemas” – A #dermatology #meded #FOAMEd #tweetorial. pc:@dermnetnz
Ever get all the different #dermatologic terms jumbled up? Was it erythema nodosum, erythema migrans, or erythema multiforme?
Honest poll – Ever write “rash” b/c you couldn’t remember the diagnosis?
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All kidding aside, these terms can get confusing. Remember though, derm terms are usually just descriptors of what you see. The name tells you all you need to know.
For example: Acute Generalized Exanthematous Pustulosis (AGEP) = pustules suddenly appeared everywhere!
All kidding aside, these terms can get confusing. Remember though, derm terms are usually just descriptors of what you see. The name tells you all you need to know.
For example: Acute Generalized Exanthematous Pustulosis (AGEP) = pustules suddenly appeared everywhere!
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So, the “erythemas.” First off, what does “erythema” actually mean? Well, according to my Google machine, it's from the Greek root “eruthros” meaning “red.” So "erythema" doesn’t add much to our knowledge of what the rash looks like other than it’s red, and so, likely inflamed
So, the “erythemas.” First off, what does “erythema” actually mean? Well, according to my Google machine, it's from the Greek root “eruthros” meaning “red.” So "erythema" doesn’t add much to our knowledge of what the rash looks like other than it’s red, and so, likely inflamed
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A reminder to everyone that since erythema = red, when you’re describing a rash, try using the actual color instead of erythematous. Light pink, dark red, purple – all say something more than “erythematous.”
FWIW, a google search also shows how frequently the word is used!
A reminder to everyone that since erythema = red, when you’re describing a rash, try using the actual color instead of erythematous. Light pink, dark red, purple – all say something more than “erythematous.”
FWIW, a google search also shows how frequently the word is used!
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So let’s get into the specific diagnoses.
Erythema NODosum (EN) clinically presents with Red NODules on the shins. Usually triggered by drug or infection, treating the underlying cause or the sxs is key.
Check out my #tweetorial on EN for more info:
So let’s get into the specific diagnoses.
Erythema NODosum (EN) clinically presents with Red NODules on the shins. Usually triggered by drug or infection, treating the underlying cause or the sxs is key.
Check out my #tweetorial on EN for more info:
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Interestingly, just move those nodules to the back of the calves, and we think about another “erythema.”
Erythema INDURATum presents with these RED INDURATED nodules on the calves.
This can be a tuberculid reaction (reactive to TB somewhere). Bx & tissue cx recommended!
Interestingly, just move those nodules to the back of the calves, and we think about another “erythema.”
Erythema INDURATum presents with these RED INDURATED nodules on the calves.
This can be a tuberculid reaction (reactive to TB somewhere). Bx & tissue cx recommended!
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Erythema multiforme (EM) is weirdly named, as multiforme = multiple forms. But, we usually think of EM as being papular (raised) targets lesions (red, pale, red) on the acral surfaces.
See my #tweetorial on EM for more details.
Erythema multiforme (EM) is weirdly named, as multiforme = multiple forms. But, we usually think of EM as being papular (raised) targets lesions (red, pale, red) on the acral surfaces.
See my #tweetorial on EM for more details.
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Erythema chronicum migrans (ECM) is associated with Lyme.
You can remember this as ECM has 3 words in the dx, and Lyme has 3 stages of disease (early localized, early disseminated, late disseminated).
Remember, a targetoid lesion at the site of the tick bite is expected.
Erythema chronicum migrans (ECM) is associated with Lyme.
You can remember this as ECM has 3 words in the dx, and Lyme has 3 stages of disease (early localized, early disseminated, late disseminated).
Remember, a targetoid lesion at the site of the tick bite is expected.
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A reminder too that in darker skin types, that redness can be harder to see. Thanks to @BrwnSkinMatters for collating a bunch of photos for us to learn from! Here's an example of ECM in darker skin.
A reminder too that in darker skin types, that redness can be harder to see. Thanks to @BrwnSkinMatters for collating a bunch of photos for us to learn from! Here's an example of ECM in darker skin.
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Let’s talk about Erythema Annulare Centrifugum (EAC). It’s often confused with tinea b/c it’s annular & scaly, but notice how in EAC (pic1) the scale is on the trailing edge (behind the red rim) instead of the leading edge in tinea (pic2)!
Let’s talk about Erythema Annulare Centrifugum (EAC). It’s often confused with tinea b/c it’s annular & scaly, but notice how in EAC (pic1) the scale is on the trailing edge (behind the red rim) instead of the leading edge in tinea (pic2)!
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EAC is associated with tinea, so I’ll often look at the feet to see if there’s tinea pedis. Treating the tinea will make the EAC go away too. It can be associated with other things, like drugs, rheumatologic diseases, and in rare instances, cancer.
EAC is associated with tinea, so I’ll often look at the feet to see if there’s tinea pedis. Treating the tinea will make the EAC go away too. It can be associated with other things, like drugs, rheumatologic diseases, and in rare instances, cancer.
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For the #pediatrics crowd: erythema infectiosum. This Parvovirus rxn is usually noninfectious when the exanthem (slapped cheeks) appears! This➡️ 2nd phase after 1-4 days (macules/papules on extremities➡️trunk), then➡️3rd lacy/reticulate redness afterward. Supportive care!
For the #pediatrics crowd: erythema infectiosum. This Parvovirus rxn is usually noninfectious when the exanthem (slapped cheeks) appears! This➡️ 2nd phase after 1-4 days (macules/papules on extremities➡️trunk), then➡️3rd lacy/reticulate redness afterward. Supportive care!
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One more for the #twitternists: Erythema toxicum neonatorum – occurs in ~ 50% of full term newborns. Lesions are pustules or papules on a broad erythematous base. They can be anywhere but usually spare the palms and soles. Babies are asx, & a smear would show eosinophils.
One more for the #twitternists: Erythema toxicum neonatorum – occurs in ~ 50% of full term newborns. Lesions are pustules or papules on a broad erythematous base. They can be anywhere but usually spare the palms and soles. Babies are asx, & a smear would show eosinophils.
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Then there’s a whole list that dermatologists will nerd out about:
E. marginatum (rheumatic fever)
E. elevatum diutinum (vasculitis)
E. ab igne (external heat)
E. nodosum leprosum (leprosy)
E. dyschromicum perstans (ashy derm)
E. gyratum repens (paraneoplastic - see pic!)
Then there’s a whole list that dermatologists will nerd out about:
E. marginatum (rheumatic fever)
E. elevatum diutinum (vasculitis)
E. ab igne (external heat)
E. nodosum leprosum (leprosy)
E. dyschromicum perstans (ashy derm)
E. gyratum repens (paraneoplastic - see pic!)
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RECAP:
- Erythema means red, so use the actual color to describe what you see.
- EM, EN, ECM aren't the same. Use my (albeit juvenile) mnemonics to remember the differences.
- When it doubt, derm it out! (Call us!)
Hope this helps someone in #medtwitter or #dermtwitter!
RECAP:
- Erythema means red, so use the actual color to describe what you see.
- EM, EN, ECM aren't the same. Use my (albeit juvenile) mnemonics to remember the differences.
- When it doubt, derm it out! (Call us!)
Hope this helps someone in #medtwitter or #dermtwitter!
