Late-stage nodular erythema elevatum diutinum mimicking sclerotic fibroma

J Cutan Pathol. 2018 Jan;45(1):94-96. doi: 10.1111/cup.13066. Epub 2017 Nov 22.

Abstract

Erythema elevatum diutinum (EED) is a rare, cutaneous vasculitis of uncertain origin. EED can present clinically as chronic bilateral, symmetrical, periarticular papules, plaques and nodules. We report here an unusual case of EED presenting as multiple, densely fibrosing nodules on the feet of a 60-year-old human immunodeficiency virus positive woman. The initial evaluation of the patient was complicated by the strong histologic resemblance of multiple lesions to sclerotic fibroma, a cutaneous manifestation of Cowden disease. Our case highlights the important features that distinguish these 2 pathologic entities.

Keywords: cutaneous vasculitis; erythema elevatum diutinum; histopathologic mimicry; sclerotic fibroma.

Publication types

  • Case Reports

MeSH terms

  • Diagnosis, Differential
  • Female
  • Fibroma / diagnosis
  • Fibroma / pathology
  • HIV Infections / complications*
  • Hamartoma Syndrome, Multiple / diagnosis
  • Hamartoma Syndrome, Multiple / pathology
  • Humans
  • Immunocompromised Host*
  • Middle Aged
  • Vasculitis, Leukocytoclastic, Cutaneous / diagnosis
  • Vasculitis, Leukocytoclastic, Cutaneous / immunology*
  • Vasculitis, Leukocytoclastic, Cutaneous / pathology*

Supplementary concepts

  • Erythema elevatum diutinum