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A Case of Erythema Elevatum Diutinum (EED) Exhibiting A Keloid-Like Appearance

INTRODUCTION: Most severe-appearing keloids tend to occur around joints because of the increased extensional stimulation of the scar in those areas. However, erythema elevatum diutinum (EED) appears more commonly on friction sites including extensor surfaces of the extremities and dorsal surfaces of...

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Autores principales: Awan, Bint-e, Noda, Yoshihiro, Yabuno, Yuto, Hokazono, Yu, Ansai, Shinichi, Ogawa, Rei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Healthcare 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8611145/
https://www.ncbi.nlm.nih.gov/pubmed/34778936
http://dx.doi.org/10.1007/s13555-021-00639-0
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author Awan, Bint-e
Noda, Yoshihiro
Yabuno, Yuto
Hokazono, Yu
Ansai, Shinichi
Ogawa, Rei
author_facet Awan, Bint-e
Noda, Yoshihiro
Yabuno, Yuto
Hokazono, Yu
Ansai, Shinichi
Ogawa, Rei
author_sort Awan, Bint-e
collection PubMed
description INTRODUCTION: Most severe-appearing keloids tend to occur around joints because of the increased extensional stimulation of the scar in those areas. However, erythema elevatum diutinum (EED) appears more commonly on friction sites including extensor surfaces of the extremities and dorsal surfaces of joints. EEDs also presents as red-brown and elevated lesions. CASE PRESENTATION: In this report, we describe a 42-year-old female who presented with firm, sporadic, brown-colored raised nodules on her bilateral lower extremities. As the appearance of these nodules resembled keloids, resection of the affected area with subsequent radiation therapy was initiated. However, histopathologic examination performed after treatment revealed tuberous lesions in the dermis, increased wired collagen fibers, neutrophilic infiltrate with nuclear dust, and edematous endothelial cells in the small vessels. Consequently, the patient was later diagnosed with EED. Post-surgery, no recurrence or abnormal scars appeared. DISCUSSION: Whereas clinical findings of EED are similar to that of keloids, the mechanisms of the two conditions differ considerably, leading to varying management strategies. EEDs can be misdiagnosed as keloids on several grounds; they can both appear morphologically similar, exhibit as stiff lesions, demonstrate chronic inflammation of the reticular dermis, and appear anywhere on the body. The only definitive method of differentiating between the two is through histopathologic examination. CONCLUSION: EED should be considered as one of the differential diagnoses for any patients presenting with keloid-like lesions on friction sites and biopsy should be performed prior to resection and radiotherapy.
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spelling pubmed-86111452021-12-10 A Case of Erythema Elevatum Diutinum (EED) Exhibiting A Keloid-Like Appearance Awan, Bint-e Noda, Yoshihiro Yabuno, Yuto Hokazono, Yu Ansai, Shinichi Ogawa, Rei Dermatol Ther (Heidelb) Case Report INTRODUCTION: Most severe-appearing keloids tend to occur around joints because of the increased extensional stimulation of the scar in those areas. However, erythema elevatum diutinum (EED) appears more commonly on friction sites including extensor surfaces of the extremities and dorsal surfaces of joints. EEDs also presents as red-brown and elevated lesions. CASE PRESENTATION: In this report, we describe a 42-year-old female who presented with firm, sporadic, brown-colored raised nodules on her bilateral lower extremities. As the appearance of these nodules resembled keloids, resection of the affected area with subsequent radiation therapy was initiated. However, histopathologic examination performed after treatment revealed tuberous lesions in the dermis, increased wired collagen fibers, neutrophilic infiltrate with nuclear dust, and edematous endothelial cells in the small vessels. Consequently, the patient was later diagnosed with EED. Post-surgery, no recurrence or abnormal scars appeared. DISCUSSION: Whereas clinical findings of EED are similar to that of keloids, the mechanisms of the two conditions differ considerably, leading to varying management strategies. EEDs can be misdiagnosed as keloids on several grounds; they can both appear morphologically similar, exhibit as stiff lesions, demonstrate chronic inflammation of the reticular dermis, and appear anywhere on the body. The only definitive method of differentiating between the two is through histopathologic examination. CONCLUSION: EED should be considered as one of the differential diagnoses for any patients presenting with keloid-like lesions on friction sites and biopsy should be performed prior to resection and radiotherapy. Springer Healthcare 2021-11-14 /pmc/articles/PMC8611145/ /pubmed/34778936 http://dx.doi.org/10.1007/s13555-021-00639-0 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by-nc/4.0/Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Case Report
Awan, Bint-e
Noda, Yoshihiro
Yabuno, Yuto
Hokazono, Yu
Ansai, Shinichi
Ogawa, Rei
A Case of Erythema Elevatum Diutinum (EED) Exhibiting A Keloid-Like Appearance
title A Case of Erythema Elevatum Diutinum (EED) Exhibiting A Keloid-Like Appearance
title_full A Case of Erythema Elevatum Diutinum (EED) Exhibiting A Keloid-Like Appearance
title_fullStr A Case of Erythema Elevatum Diutinum (EED) Exhibiting A Keloid-Like Appearance
title_full_unstemmed A Case of Erythema Elevatum Diutinum (EED) Exhibiting A Keloid-Like Appearance
title_short A Case of Erythema Elevatum Diutinum (EED) Exhibiting A Keloid-Like Appearance
title_sort case of erythema elevatum diutinum (eed) exhibiting a keloid-like appearance
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8611145/
https://www.ncbi.nlm.nih.gov/pubmed/34778936
http://dx.doi.org/10.1007/s13555-021-00639-0
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