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Erythema of acral regions

MedGen UID:
384009
•Concept ID:
C1856900
•
Finding
Synonym: ERYTHEMA OF ACRAL REGIONS
 
Monarch Initiative: MONDO:0009195
OMIM®: 227000

Clinical features

From HPO
Clubfoot
MedGen UID:
3130
•Concept ID:
C0009081
•
Congenital Abnormality
Clubfoot is a congenital limb deformity defined as fixation of the foot in cavus, adductus, varus, and equinus (i.e., inclined inwards, axially rotated outwards, and pointing downwards) with concomitant soft tissue abnormalities (Cardy et al., 2007). Clubfoot may occur in isolation or as part of a syndrome (e.g., diastrophic dysplasia, 222600). Clubfoot has been reported with deficiency of long bones and mirror-image polydactyly (Gurnett et al., 2008; Klopocki et al., 2012).
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Abnormality of the dentition
MedGen UID:
78084
•Concept ID:
C0262444
•
Finding
Any abnormality of the teeth.
See: Feature record | Search on this feature
Erythema
MedGen UID:
11999
•Concept ID:
C0041834
•
Disease or Syndrome
Redness of the skin, caused by hyperemia of the capillaries in the lower layers of the skin.
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Professional guidelines

PubMed

Different patterns of skin manifestations associated with parvovirus B19 primary infection in adults.
Mage V, Lipsker D, Barbarot S, Bessis D, Chosidow O, Del Giudice P, Aractingi S, Avouac J, Bernier C, Descamps V, Dupin N
J Am Acad Dermatol 2014 Jul;71(1):62-9. Epub 2014 Apr 14 doi: 10.1016/j.jaad.2014.02.044. PMID: 24726401
Leukocytoclastic vasculitis and necrolytic acral erythema in patients with hepatitis C infection: do viral load and viral genotype play a role?
El-Darouti MA, Mashaly HM, El-Nabarawy E, Eissa AM, Abdel-Halim MR, Fawzi MM, El-Eishi NH, Tawfik SO, Zaki NS, Zidan AZ, Fawzi M, Abdelaziz M, Fawzi MM, Shaker OG
J Am Acad Dermatol 2010 Aug;63(2):259-65. Epub 2010 May 11 doi: 10.1016/j.jaad.2009.07.050. PMID: 20462666

Recent clinical studies

Etiology

COVID 19-associated chilblain-like acral lesions among children and adolescents: an Italian retrospective, multicenter study.
Romita P, Maronese CA, DE Marco A, Balestri R, Belloni Fortina A, Brazzelli V, Colonna C, DI Lernia V, El Hachem M, Fabbrocini G, Foti C, Frasin LA, Guarneri C, Guerriero C, Guida S, Locatelli A, Neri I, Occella C, Offidani A, Oranges T, Pellacani G, Stinco G, Stingeni L, Barbagallo T, Campanati A, Cannavò SP, Caroppo F, Cavalli R, Costantini A, Cucchia R, Diociaiuti A, Filippeschi C, Francomano M, Giancristoforo S, Giuffrida R, Martina E, Monzani NA, Nappa P, Pastorino C, Patrizi A, Peccerillo F, Peris K, Recalcati S, Rizzoli L, Simonetti O, Vastarella M, Virdi A, Marzano AV, Bonamonte D
Ital J Dermatol Venerol 2023 Apr;158(2):117-123. doi: 10.23736/S2784-8671.23.07539-4. PMID: 37153946
Reality of drug-induced erythema multiforme: A French pharmacovigilance study.
Demouche S, Bettuzzi T, Sbidian E, Laugier Castellan D, Osmont MN, Ingen-Housz-Oro S, Lebrun-Vignes B
Therapie 2023 Nov-Dec;78(6):711-719. Epub 2023 Mar 10 doi: 10.1016/j.therap.2023.03.004. PMID: 37024401
Assessment of Acute Acral Lesions in a Case Series of Children and Adolescents During the COVID-19 Pandemic.
Roca-Ginés J, Torres-Navarro I, Sánchez-Arráez J, Abril-Pérez C, Sabalza-Baztán O, Pardo-Granell S, Martínez I Cózar V, Botella-Estrada R, Évole-Buselli M
JAMA Dermatol 2020 Sep 1;156(9):992-997. doi: 10.1001/jamadermatol.2020.2340. PMID: 32584397Free PMC Article
Acral manifestations of viral infections.
Adışen E, Önder M
Clin Dermatol 2017 Jan-Feb;35(1):40-49. Epub 2016 Sep 10 doi: 10.1016/j.clindermatol.2016.09.006. PMID: 27938811
Pediatric Erythema Multiforme in the Emergency Department: More Than "Just a Rash".
Read J, Keijzers GB
Pediatr Emerg Care 2017 May;33(5):320-324. doi: 10.1097/PEC.0000000000000618. PMID: 26555305

Diagnosis

COVID 19-associated chilblain-like acral lesions among children and adolescents: an Italian retrospective, multicenter study.
Romita P, Maronese CA, DE Marco A, Balestri R, Belloni Fortina A, Brazzelli V, Colonna C, DI Lernia V, El Hachem M, Fabbrocini G, Foti C, Frasin LA, Guarneri C, Guerriero C, Guida S, Locatelli A, Neri I, Occella C, Offidani A, Oranges T, Pellacani G, Stinco G, Stingeni L, Barbagallo T, Campanati A, Cannavò SP, Caroppo F, Cavalli R, Costantini A, Cucchia R, Diociaiuti A, Filippeschi C, Francomano M, Giancristoforo S, Giuffrida R, Martina E, Monzani NA, Nappa P, Pastorino C, Patrizi A, Peccerillo F, Peris K, Recalcati S, Rizzoli L, Simonetti O, Vastarella M, Virdi A, Marzano AV, Bonamonte D
Ital J Dermatol Venerol 2023 Apr;158(2):117-123. doi: 10.23736/S2784-8671.23.07539-4. PMID: 37153946
Reality of drug-induced erythema multiforme: A French pharmacovigilance study.
Demouche S, Bettuzzi T, Sbidian E, Laugier Castellan D, Osmont MN, Ingen-Housz-Oro S, Lebrun-Vignes B
Therapie 2023 Nov-Dec;78(6):711-719. Epub 2023 Mar 10 doi: 10.1016/j.therap.2023.03.004. PMID: 37024401
Assessment of Acute Acral Lesions in a Case Series of Children and Adolescents During the COVID-19 Pandemic.
Roca-Ginés J, Torres-Navarro I, Sánchez-Arráez J, Abril-Pérez C, Sabalza-Baztán O, Pardo-Granell S, Martínez I Cózar V, Botella-Estrada R, Évole-Buselli M
JAMA Dermatol 2020 Sep 1;156(9):992-997. doi: 10.1001/jamadermatol.2020.2340. PMID: 32584397Free PMC Article
Current Perspectives on Erythema Multiforme.
Lerch M, Mainetti C, Terziroli Beretta-Piccoli B, Harr T
Clin Rev Allergy Immunol 2018 Feb;54(1):177-184. doi: 10.1007/s12016-017-8667-7. PMID: 29352387
Pediatric Erythema Multiforme in the Emergency Department: More Than "Just a Rash".
Read J, Keijzers GB
Pediatr Emerg Care 2017 May;33(5):320-324. doi: 10.1097/PEC.0000000000000618. PMID: 26555305

Therapy

Bullous lupus erythematosus with an erythema gyratum repens-like pattern.
Da Silva Sousa AC, Campos M, Oliveira A, Menezes N, Tente D, Baptista A
Dermatol Online J 2019 Jan 15;25(1) PMID: 30710900
Current Perspectives on Erythema Multiforme.
Lerch M, Mainetti C, Terziroli Beretta-Piccoli B, Harr T
Clin Rev Allergy Immunol 2018 Feb;54(1):177-184. doi: 10.1007/s12016-017-8667-7. PMID: 29352387
Pretreatment with 5-Fluorouracil Cream Enhances the Efficacy of Daylight-mediated Photodynamic Therapy for Actinic Keratosis.
Nissen CV, Heerfordt IM, Wiegell SR, Mikkelsen CS, Wulf HC
Acta Derm Venereol 2017 May 8;97(5):617-621. doi: 10.2340/00015555-2612. PMID: 28093604
Volar melanotic macules in a gardener: a case report and review of the literature.
Blossom J, Altmayer S, Jones DM, Slominski A, Carlson JA
Am J Dermatopathol 2008 Dec;30(6):612-9. doi: 10.1097/DAD.0b013e318184bc57. PMID: 19033941
Familial erythema of acral regions.
Bryan HG, Coskey RJ
Arch Dermatol 1967 May;95(5):483-6. PMID: 6023700

Prognosis

Acral lesions in a pediatric population during the COVID-19 pandemic: a case series of 36 patients from a single hospital in Spain.
Rosés-Gibert P, Gimeno Castillo J, Saenz Aguirre A, De la Torre Gomar FJ, Carnero González L, Martinez de Lagrán Alvarez de Arcaya Z, Gonzalez-Perez R
World J Pediatr 2020 Dec;16(6):629-632. Epub 2020 Sep 8 doi: 10.1007/s12519-020-00390-0. PMID: 32901377Free PMC Article
Classification of the cutaneous manifestations of COVID-19: a rapid prospective nationwide consensus study in Spain with 375 cases.
Galván Casas C, Català A, Carretero Hernández G, Rodríguez-Jiménez P, Fernández-Nieto D, Rodríguez-Villa Lario A, Navarro Fernández I, Ruiz-Villaverde R, Falkenhain-López D, Llamas Velasco M, García-Gavín J, Baniandrés O, González-Cruz C, Morillas-Lahuerta V, Cubiró X, Figueras Nart I, Selda-Enriquez G, Romaní J, Fustà-Novell X, Melian-Olivera A, Roncero Riesco M, Burgos-Blasco P, Sola Ortigosa J, Feito Rodriguez M, García-Doval I
Br J Dermatol 2020 Jul;183(1):71-77. Epub 2020 Jun 10 doi: 10.1111/bjd.19163. PMID: 32348545Free PMC Article
Clinical and histologic features of Mycoplasma pneumoniae-related erythema multiforme: A single-center series of 33 cases compared with 100 cases induced by other causes.
Amode R, Ingen-Housz-Oro S, Ortonne N, Bounfour T, Pereyre S, Schlemmer F, Bequignon E, Royer G, Wolkenstein P, Chosidow O
J Am Acad Dermatol 2018 Jul;79(1):110-117. Epub 2018 Mar 17 doi: 10.1016/j.jaad.2018.03.013. PMID: 29559400
Current Perspectives on Erythema Multiforme.
Lerch M, Mainetti C, Terziroli Beretta-Piccoli B, Harr T
Clin Rev Allergy Immunol 2018 Feb;54(1):177-184. doi: 10.1007/s12016-017-8667-7. PMID: 29352387
Vasospasm Is a Consistent Finding in Pernio (Chilblains) and a Possible Clue to Pathogenesis.
Shahi V, Wetter DA, Cappel JA, Davis MD, Spittell PC
Dermatology 2015;231(3):274-9. Epub 2015 Aug 12 doi: 10.1159/000437224. PMID: 26278705

Clinical prediction guides

COVID 19-associated chilblain-like acral lesions among children and adolescents: an Italian retrospective, multicenter study.
Romita P, Maronese CA, DE Marco A, Balestri R, Belloni Fortina A, Brazzelli V, Colonna C, DI Lernia V, El Hachem M, Fabbrocini G, Foti C, Frasin LA, Guarneri C, Guerriero C, Guida S, Locatelli A, Neri I, Occella C, Offidani A, Oranges T, Pellacani G, Stinco G, Stingeni L, Barbagallo T, Campanati A, Cannavò SP, Caroppo F, Cavalli R, Costantini A, Cucchia R, Diociaiuti A, Filippeschi C, Francomano M, Giancristoforo S, Giuffrida R, Martina E, Monzani NA, Nappa P, Pastorino C, Patrizi A, Peccerillo F, Peris K, Recalcati S, Rizzoli L, Simonetti O, Vastarella M, Virdi A, Marzano AV, Bonamonte D
Ital J Dermatol Venerol 2023 Apr;158(2):117-123. doi: 10.23736/S2784-8671.23.07539-4. PMID: 37153946
Reality of drug-induced erythema multiforme: A French pharmacovigilance study.
Demouche S, Bettuzzi T, Sbidian E, Laugier Castellan D, Osmont MN, Ingen-Housz-Oro S, Lebrun-Vignes B
Therapie 2023 Nov-Dec;78(6):711-719. Epub 2023 Mar 10 doi: 10.1016/j.therap.2023.03.004. PMID: 37024401
Clinical and histologic features of Mycoplasma pneumoniae-related erythema multiforme: A single-center series of 33 cases compared with 100 cases induced by other causes.
Amode R, Ingen-Housz-Oro S, Ortonne N, Bounfour T, Pereyre S, Schlemmer F, Bequignon E, Royer G, Wolkenstein P, Chosidow O
J Am Acad Dermatol 2018 Jul;79(1):110-117. Epub 2018 Mar 17 doi: 10.1016/j.jaad.2018.03.013. PMID: 29559400
Necrolytic acral erythema: a cutaneous sign of hepatitis C virus infection.
Abdallah MA, Ghozzi MY, Monib HA, Hafez AM, Hiatt KM, Smoller BR, Horn TD
J Am Acad Dermatol 2005 Aug;53(2):247-51. doi: 10.1016/j.jaad.2005.04.049. PMID: 16021118
Necrolytic migratory erythema: clinicopathologic study of 13 cases.
Pujol RM, Wang CY, el-Azhary RA, Su WP, Gibson LE, Schroeter AL
Int J Dermatol 2004 Jan;43(1):12-8. doi: 10.1111/j.1365-4632.2004.01844.x. PMID: 14693015

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