Erythema elevatum diutinum associated with scleritis

Erythema elevatum diutinum (EED) is a chronic and rare variant of leukocytoclastic vasculitis that is being reported nowadays frequently in association with HIV infection. It clinically manifests as asymptomatic to tender erythematous papules, plaques and nodules, usually with acral distribution and is rarely accompanied by systemic complaints other than arthralgia. The reported associations include preceding upper respiratory infections, hematological malignancies, lymphomas and monoclonal gammopathies. Here we report a 45 year old man with multiple joint pains, tender nodules over palms and soles and ocular pain and congestion, who was subsequently diagnosed as a case of EED and scleritis following histopathological examination. Skin as well as ocular complaints completely subsided with Dapsone monotherapy.