Abstract

We present a 52‐year‐old lady with a 5‐year history of a persistent, widespread, annular erythema associated with lethargy, arthralgias, and an inflammatory synovitis. Skin biopsies have shown mild lichenoid change at the dermoepidermal junction; and oedema, mucin, and a diffuse lymphocytic and eosinophilic infiltrate without flame figures in the dermis. A full blood count including an eosinophil count; liver, renal and thyroid function; rheumatoid factor, ANA, ENA, dsDNA, complement studies, immunoglobulins, and serum protein elecrophoresis and immunoelectrophoresis; flow cytometry of peripheral blood for lymphocyte markers; stool examination for ova, cysts and parasites; and a CT scan of the chest and abdomen have shown no significant abnormality. Hydroxychloroquine has stabilised but not cleared her condition.Cases presenting clinically with annular erythema and histologically with eosinophilic cellulitis are difficult to classify. We discuss the classification of this case in the context of the literature.

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