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Erythema elevatum diutinum is a chronic and uncommon dermatosis that is considered to be a variation of leukocytoclastic vasculitis. The exect reason of erythema elevatum diutinum is unidentified, although the pathogenesis is believed to be exempt complex-mediated. It can happen at any age. However, it is mostly an adult disease that occurs from the third to sixth decade of life. Associated infections include bacterial, viral, tuberculosis, hepatitis, and syphilis. Various conditions have been reported with this disease, which include hematologic and autoimmune disorders, such as rheumatoid arthritis, ulcerative colitis, pyoderma gangrenosum, type I diabetes mellitus, crohn's disease, relapsing polychondritis, and gluten-sensitive enteropathy. Symptoms can exacerbate after vulnerability to cool. The lesions tend to spread symmetrically on the extensor surfaces of the extremities and on the buttocks, and have a persistent character. Patients usually present with persistent, firm lesions on the extensor surfaces of their skin, especially over the joints. These lesions are most often nodules and round or oval plaques. However, on rare occasions, blisters and ulcers may also appear. The lesions can be completely asymptomatic, painful, or cause a sensation of burning or itching. These symptoms can be exacerbated by cold. Improvement may ensue from handling of an underlying reason or transmission. Medication can be used to restrict advancement of the disease. Dapsone is considered the drug of selection for erythema elevatum diutinum, mainly because of its speedy onslaught of activity and clinical experience has shown better responses. Surgical excision of the lesions is sometimes performed to provide symptomatic relief. Other drugs that have been used include niacinamide, colchicine, chloroquine, clofazimine and cyclophosphamide. Oral corticosteroids are generally ineffective. Dapsone and other therapies can be successful in limiting the progression of the disease. Dapsone treatment is partly effective but complete healing of the erythema elevatum diutinum lesions is achieved only after the introduction of a strict gluten-free diet. Systemic corticosteroids are generally ineffective. Article Tags: Erythema Elevatum Diutinum, Erythema Elevatum, Elevatum Diutinum
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