Erythema Elevatum Diutinum and Crohn Disease: A Common Pathogenic Role for Measles Virus?

Abstract

Erythema elevatum diutinum (EED) is a rare skin disease characterized by indolent purple, red, or yellowish papules and nodules, usually occurring symmetrically on extensor surfaces around acral joints. Histological features include a leukocytoclastic vasculitis of the mid- and upper-dermal vessels with fibrinoid necrosis, a dense dermal neutrophilic infiltrate, and, in older lesions, fibrosis.¹The most frequently reported condition associated with EED is hypergammaglobulinemia, but it is also reported in association with recurrent infections, rheumatoid arthritis, systemic lupus erythematosus, human immunodeficiency virus infection, and ulcerative colitis.¹To our knowledge, EED has been reported in only 1 other case of Crohn disease (CD).²We report a second case of EED occurring in association with CD and the presence of persistent measles virus particles in granulomas in both gastrointestinal and skin lesions. <h3>Report of a Case.</h3> A 25-year-old West Indian woman, born in the United Kingdom, presented in March