REFERENCIAS BIBLIOGRÁFICAS / BIBLIOGRAPHICAL REFERENCES

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1.) Erythema gyratum repens: A paraneoplastic eruption; Clinical review 

2.) Cutaneous manifestations of cancer. 

3.) Erythema gyratum repens in association with renal cell carcinoma.  

4.) Erythema gyratum repens: another case of a rare disorder but no new insight into pathogenesis. 

5.) Cutaneous paraneoplastic syndromes in solid tumors. 

6.) Erythema gyratum repens unassociated with underlying malignancy. 

7.) Erythema gyratum repens-like eruption in a patient with Sjogren syndrome. 

8.) Paraneoplastic bullous pemphigoid resembling erythema gyratum repens. 

9.) Eruption resembling erythema gyratum repens in linear IgA dermatosis. 

10.) Erythema gyratum repens associated with hypereosinophilic syndrome. 

11.) Erythema gyratum repens. A case studied with immunofluorescence,  immunoelectron microscopy and immunohistochemistry. 

12.) Erythema gyratum repens: direct immunofluorescence microscopic findings. 

13.) Erythema gyratum repens without underlying disease. 

14.)Reactive erythemas: erythema annulare centrifugum and erythema gyratum  repens. 

15.) Subcorneal accumulation of Langerhans cells in erythema gyratum repens. 

16.) Erythema gyratum repens in a healthy woman. 

17.)[Gammel's non-paraneoplastic erythema gyratum repens]. 

18.) [Erythema gyratum repens type eruption]. 

19.) A mechanism of peripheral spread or localization of inflammatory  reactions--role of the localized ground substance adaptive phenomenon. 

20.) Episodic erythema gyratum repens with ichthyosis and palmoplantar  hyperkeratosis without signs of internal malignancy. 

21.) Erythema gyratum repens. A cutaneous marker of malignancy. 

22.) Bullous pemphigoid with figurate erythema associated with carcinoma of the bronchus. 

23.) Erythema figuratum versus erythema gyratum repens. 

24.) Erythema gyratum repens, a stage in the resolution of pityriasis rubra  pilaris? 

25.)[Erythema gyratum repens--a paraneoplastic dermatosis]. 

26.)Erythema gyratum repens unassociated with internal malignancy. 

27.) Erythema gyratum repens. 

28.) Gyrate erythema. 

29.) Infantile epidermodysplastic erythema gyratum responsive to imidazoles. A new entity? 

30.) Erythema gyratum repens with associated squamous cell carcinoma of the lung. 

31.) [Cutaneous paraneoplastic syndromes]. 

32.) [Erythema gyratum repens and primary bronchial cancer. Disappearance of the dermatosis under general corticoid therapy]. 

33.) [Erythema gyratum repens of Gammel and Hodgkin's disease]. 

34.) Erythema gyratum repens-like figurate eruption in bullous pemphigoid. 

35.) [Erythema gyratum repens]. 

36.) [Erythema gyratum repens]. 

37.) Erythema gyratum repens: spontaneous resolution in a healthy man. 

38.) Erythema gyratum repens with pulmonary tuberculosis. 

39.) [Gammel's erythema gyratum repens and acquired ichthyosis associated with esophageal carcinoma]. 

40.) [Erythema gyratum repens or Gammel paraneoplastic syndrome. A case with 

epidermoid carcinoma developed on a megaesophagus]. 

41.) Erythema gyratum repens--an immunologically mediated dermatosis? 

42.) Erythema gyratum repens with metastatic adenocarcinoma. 

43.) [Erythema gyratum repens (Gammel's syndrome)] 

44.) Figurate and bullous eruption in association with breast carcinoma. 

45.) [Erythema gyratum repens associated with bronchial carcinoma] 

46.) Erythema gyratum repens. Reports of two further cases associated with  carcinoma. 

47.) Carcinoma of the breast, pemphigus vulgaris and gyrate erythema. 

48.) [Premycotic erythema simulating erythema gyratum repens]. 

49.) [An unusual paraneoplastic syndrome: erythema "gyratum repens" or Gammel's syndrome]. 

50.) [An unusual paraneoplastic syndrome: erythema gyratum repens. Its relation with bronchial cancer]. 

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1.) Erythema gyratum repens: A paraneoplastic eruption; Clinical review 

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SOURCE: J AM ACAD DERMATOL 1992;26:757-62. 

Alan S. Boyd, MD, Kenneth H. Neldner, MD, and Alan Menter, MD Lubbock and 

Dallas, Texas 

 

 Erythema gyratum repens is a slowly expanding, mildly scaling dermatosis  with a "wood-grain" pattern and is seen in patients with an underlying  malignancy. To date only 49 cases have appeared in the literature, 41 of  which (84%) were associated with a neoplasm, most commonly of the lung.  Several patients also had pruritus, palmoplantar keratoderma, ichthyosis, 

vesiculobullous lesions, and/ or eosinophilia. Histopathologic findings are  nonspecific. The skin findings usually disappear with therapy for the  underlying malignancy. (J AM ACAD DERMATOL 1992;26:757-62.)   

The skin may be the first organ to heraLd {he presence of a visceral  malignancy. Paraneoplastic eruptions seen with cancer include acanthosis  nigricans, acquired ichthyosis, pancreatic fat necrosis, migratory  thrombophlebitis, Sweet's syndrome, hypertrichosis lanuginosa acquisita,  and others, but one of the most specific dermatoses associated with  underlying neoplasia is that of erythema gyratum repens (EGR). We discuss  this dermatosis and review the literature. 

HISTORY 

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Gammel,1 described the first case of EGR in 1953. His patient, a  55-year-old woman, developed a scaling, pruritic eruption on her trunk and  extremities reminiscent of "knotty cypress wood grain." The eruptions was  noted to extend about 1 cm per day. A palpable axillary lymph node revealed  metastatic adenocarcinoma of the breast. A radical mastectomy was  performed that led to fading of the eruption within 48 hours and complete  clearing by 6 weeks. Neither the eruption nor the tumor recurred. The  author believed this distinctive eruption had been caused by a carcinotoxin to which the host was allergic. He named it "erythema gyratum repens"  (repens from the Latin meaning to crawl or creep).2 

Since this initial description, at least 48 additional patients have been  reported.3-46 With a few exceptions,28, 31,35,36,40,42,46 all have been afflicted with an underlying malignancy, most commonly of the lung. Figurate erythemas have been known to occur With neoplasia,47 but EGR is the most specific and may be the most distinctive. 

CLINICAL FINDINGS

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EGR displays concentric erythematous bands,48 predominantly on the trunk and  extremities. The hands, feet, and face are usually spared.2'49  The pattern of EGR has been described as wood-grained,17' 25, 28, 35, 43  serpiginous,25 zebralike,2' 20 cypress rings,22 gyrate,43 whorled,43 and  swirls of rope25 (Fig. 1, B). The expanding borders are usually macular 

but may occasionally be palpable.20 Scale is usually present,14,20 and  trails the leading edge of the eruption,42. The eruption of EGR  moves rapidly across the surface of the skin, usually about 1 cm per day.14  EGR may involve the entire body.12'20'25'26'40 Saika et al.23 reported a  patient in whom solely right-sided truncal lesions developed with  underlying intrahepatic metastases from an adenocarcinoma of the colon. An 

overlying solitary flank lesion in a patient with ipsilateral hypernephroma has also been observed by one of us (A. M.). 

Table 1 lists the associated skin findings in these patients. Most patients  experienced some degree of pruritus.20 Ichthyosis and palmar/plantar  hyperkeratosis were also noted in 16% (8 of 49) and 10% (5 of 49) of the  patients, respectively. Three patients also had bullous pemphigoid,23,35,44 

one had pemphigus vulgaris,30 and three had unspecified vesicles and bullae,7, 13, 14 during the course of the disorder. 

An approximately 2:1 male-to-female ratio was observed. The average age was  63 years and thus far alL patients have been white. Most patients (25) had  the onset of their eruption an average of 9 months before their malignancy  was diagnosed (range 1 to 72 months). Four patients developed EGR an average of 9 months after their tumor was detected and in two cases,16,41  the eruption and neoplasm occurred simultaneously. 

Table II outlines the underlying malignancies (if any) in these patients.  Lung cancer was the most common (16 patients [32%]), followed distantly by  esophagus (4 patients [8%]) and breast (3 patients  [6%]). In three patients a metastatic malignancy was detected but the  primary site could not be identified.14,22,25  Lymphoreticular  cancers  were rare.19,37 Six patients did not have an underlying malignancy,31,35,40,42,46 and in two other cases tuberculosis,28 and the 

CREST syndrome,36 were believed to be the cause. 

Laboratory evaluations were performed in some cases. Many patients had  peripheral eosinophilia as high as 59%.29 Eosinophilia of the bone marrow  has also been described.7,46 Decreased T-ce1126'30 and increased  B-ce1126 populations have been reported, as have normal percentages for  both.31 Stankler31 demonstrated normal T-cell function in a patient with EGR but no underlying malignancy. Decreased serum levels of C3 and increased luteinizing hormone and follicle-stimulating hormone were reported in one patient.26 

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Table 1. Skin findings in 49 patients with erythema gyratum repens 

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% of      |  Affected  |   disorders  patients  | 

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50      Pruritus* 

16      Ichthyosis 22' 26, 29, 40,41,43,45,46 

lo       Palmar/plantar hyperkeratosis 6,42,45,46 

8       Pityriasis rubra pilaris 20, 40 

6       Psoriasiform lesions,10, 39,40 

6       Vesicles/bullae,7' 13, 14 

6       Bulbus pemphigoid 23,35'44 

2       Pemphigus vulgaris 30 

2       Discoid lupus erythematosus 40 

*References 1,3-7, 10, 12, 14, 17,21,22,25,27-29,37, 38,40,41,43, 45, 46, 48. 

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Table II. Underlying malignancies associated with erythema 

gyratum repens* 

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    %    |  Patients |     TyPe 

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32      Lung,4, 9, 10, 15-18, 21,26,37,39,41,43,44,45 

12      None,31,35,40,42,46 

8       Esophagus,27, 29,32, 33 

6       Breast,1, 3, 30 unknown metastatic neoplasm 4, 22, 25 

4       Cervix,5,7 pharynx,8,34 stomach,11,13 

2      Anus,24 bladder,20 bowel,23 Hodgkin's disease,38 myeloma,19                                               pancreas,41, prostate,20 tongue,6 uterus 12 

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*One patient each also had tuberculosis,28 and CREST syndrome.36 

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HISTOPATHOLOGY 

EGR is classified among the superficial erythemas,50 and as such tends to demonstrate generally nonspecific histopathologic features. Mild to moderate hyperkeratosis, parakeratosis, and spongiosis are seen.43,49, 50 Acanthosis, follicular plugging, liquefactive epidermal celLs, and  epidermopoiesis of neutrophils and eosinophils have been described.7 

The dermal vessels are surrounded by a lymphohistiocytic  infiltrate  with occasional  eosinophils.28, 37, 40, 43, 50 Mast cells may also be seen.28 The capillary endothelium may appear swollen,7 and vascular proliferation has been described.14,28 Frank vasculitis is absent. Pigmentary  incontinence,45 and papillary dermal edema,49 may also be seen. Subepidermal bullae with a sparse eosinophil infiltrate was described in a patient with EGR and bulbus pemphigoid.35 

Holt and Davies,26 described a patient with bronchogenic carcinoma who had IgG and C3 deposits at the basement membrane zone detected by direct immunofluorescence of both lesional and uninvolved skin. Indirect immunofluorescence and immunofluorescence of metastatic nodal deposits were negative. Other investigators have found negative direct and indirect  immunofluorescence in biopsy specimens of EGR.39,46 Levine et al.43 

described a patient Erythema gyratum repens  with no immune deposits at the basement membrane zone but IgM deposition on epidermal nuclei. Phenotyping of the inflammatory infiltrate in EGR demonstrated B cells and macrophages; no T cells were found.26 

DISCUSSION 

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Differential diagnosis of the figurate erythemas 

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Erythema annulare centrifugum (EAC) is morphologically similar to EGR and 

some authors believe a close relation exists between the two disorders.7 EAC usually is manifested by arcuate, polycyclic erythematous lesions that expand slowly,48 and clear centrally; it may be pruritic.49 EAC differs from EGR in that the former is slightly palpable and "moves" much more slowly.20  Histopathologic examination shows that EAC is a deep and superficial 

erythema,50,51 with a lymphohistiocytic "coat-sleeve" arrangement around blood vessels,50 mild spongiosis, and parakeratosis.49 

EAC may 2,48 or may not,2,52 be related to an underlying disease. It has been reported in association with malignancies,48 but also with infections and drug intake.2,48,53 Lesions may persist indefinitely or resolve within a few days. Erythema chronicum migrans (ECM) is an annular eruption precipitated by  the bite of an Ixodes tick and caused by infection with Borrelia 

burgdorferi.2,48,49 The lesions begin as erythematous papules that enlarge in a circular, expansile pattern to form a red, raised, scaleless eruption several centimeters in width.48 This usually begins several days to weeks after the tick bite. Serum antibodies directed against Borrelia antigens may be found. Erythema marginatum rheumaticum is usually associated with rheumatic fever in children and is rarely seen today.2 This eruption shows swift spreading, erythema, and minimal induration. However, it displays no scaling, has no symptoms, is evanescent, and demonstrates a neutrophilic infiltrate on histologic examination 49,51 Patients with glucagon-producing islet cell tumors of the pancreas may have necrolytic migratory erythema. Lesions usually begin on dependant parts of the body, periorally and perigenitally. Arcuate and circinate red plaques with erosions, vesicles, necrosis, and desquamation are present.48 Additional diseases that may occasionally enter the differential diagnosis include subacute cutaneous discoid lupus erythematosus, tinea corporis (especially tinea imbricata), psoriasis, pityriasis rubra pilaris, familial annular erythema, and keratolytic winter erythema. 

Etiology 

======== 

The cause of EGR is unclear. Gammel1 believed that the underlying tumor altered organ proteins, thereby producing endogenous allergens and creating a state of hypersensitivity to specific tumor antigens. Church10 injected suspensions of his patient's tumor (lung), unaffected pulmonary tissue, and  skin intradermally into a recovered patient. In a similar experiment  Leavelí et al.14 performed an Ouchterlony gel diffusion with their  patient's serum and a homogenate of his tumor (undifferentiated 

adenocarcinoma-type unknown).

Both produced negative results. Holt and Davies,26 the only investigators to demonstrate positive immunofluorescence of the basement membrane in skin biopsy specimens of EGR, proposed three possibilities: tumor neoantigens may invoke antibody production that cross-react with endogenous skin antigens, the tumor products may alter  certain skin antigens rendering it susceptible to immunologic attack, and tumor antigen-antibody complexes may form with subsequent cutaneous deposition. Barber et al.28 agreed that immune complex deposition may be operative but not necessarily involve tumor antigens exclusively. 

Evaluations of the cellular arm of the immune system in EGR have been sparse. Investigators do not believe these lymphocyte subsets play a  significant etiologic role in the eruption.26 Jacobs et al.30 noted a  peripheral T-cell deficiency in their patient and postulated that a  compensatory B-cell hyperactivity existed. Peripheral blood lymphocytes in one patient were not stimulated by phytohemagglutinin, tumor extract (lung), or involved skin extract.26  It seems clear that whatever factors are involved in the production of this eruption emanate from the underlying tumor. These factors may be produced from solid as well as hematopoietic tumors. Inherent in patients who develop EGR is a predisposition to react in such a manner when afflicted with cancer. Such a susceptibility could involve the human  lymphocyte antigen (HLA) system, tumoral antigen production, and/or ground substance alterations.

Specific HLA antigens have been reported to occur to a significantly greater extent in patients with malignancies of the cervix,54 testis,55 and thyroid,56 as well as in non-Hodgkin's lymphoma,57 Burkitt's lymphoma,58 and multiple myeloma.59 An interesting feature of the HLA antigens is their close relation to tumor antigens.60 These two groups of polypeptides are believed to be structurally similar with an association existing between the genes expressing both. Specific alleles among patients with cancer may render them more susceptible to the development of EGR. Second, the pathogenesis of EGR may involve a localized ground substance adaptive phenomenon. In this model granulocytes release connective tissue active peptides, which, in turn, stimulate fibroblast proliferation to produce ground substance with increased viscosity. 61 Thus inflammatory mediators are impeded from tissue spread and "walled off."

EGR might result  from a similar phenomenon involving spread of the erythematous rings  through stroma, which is unable to "wall off,' the attendant inflammation. Clearing of the eruption results from a subsequent halt of this process and clearance of the inflammatory mediators.61 Moore,62 noted that the morphologic features of EGR were similar to the patterns of aggregating  slime mould and the Belousez-Zhabotinskii chemical reaction, processes in which reaction or diffusion systems are also operative. 

Additional findings 

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Five patients with EGR (10%) also had palmo-plantar keratoderma. In three, no underlying malignancy was detected,42,46 one had lung cancer,45 and one patient had a tongue carcinoma.6 Keratotic involvement of the palms and  soles has been described previously in association with esophageal  cancer,63 and Bazex syndrome.64 Therefore it is not surprising that hyperkeratotic activity should appear in a subset of patients with a paraneoplastic eruption. These findings may be purely coincidental, but the high prevalence of palmoplantar thickening would make an association seem plausible. 

Three patients had associated bullous pemphigoid,23,35,44 one had pemphigus vulgaris,30 and three had vesiculobullous eruptions not otherwise specified.7,13, 14 All but one of these had an underlying malignancy,35 and no specific cancer was represented more than once. The association  between cancer and pemphigoid/pemphigus has been speculated on for many years, however, it is currently believed that a link probably does not exist.65,66 Because virtually all patients with EGR have had an underlying malignancy, the question arises, what of those who do not? Barber et al.28 published the first case of a patient with this eruption and pulmonary tuberculosis. Although their photograph fails to show the classic "knotty cypress" pattern, the patient's course appears consistent with EGR. Shortly thereafter,

Stankler31 described a healthy man with a 17-month history of a gyrate erythema believed to be consistent with EGR that subsequently  resolved. Examination did not reveal a malignant process. No photographs  were provided. Ingber et al.36 and Juhlin et al.46 described patients with the CREST syndrome and palmoplantar hyperkeratosis, respectively; however, their photographic documentation is questionable for EGR. In 1985 Langlois et al. 42 reported a patient with the classic eruption of EGR with a  negative evaluation and lack of malignancy at autopsy. The patient had had an unexplained 30-pound weight loss.

Risk factors for neoplasia in this patient were not discussed. Finally, Cheesbrough and Williamson,40 present the best evidence for EGR unassociated with a malignancy. Their two patients had a characteristic eruption, exhaustive work-ups, lengthy  follow-up (12 and 60 months), and, importantly, no signs or symptoms  referable to an underlying cancer. Therefore it seems clear that a few patients with EGR and no underlying malignancy do exist. However, patients who develop the typical eruption of this disorder should be assumed to have an underlying cancer until proven otherwise. 

TREATMENT 

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The most effective therapy for EGR is an exhaustive search for an underlying malignancy with treatment of the primary cause. Resolution of the Erythema gyratum repens eruption has been noted after surgery, chemotherapy, or radiotherapy.1, 3,4,9, 10'25'38 After treatment of the cancer, additional therapy for the eruption includes topical,20, 46 and systemic steroids,25, 37,42 radiotherapy,24 and azathioprine.24 Failure of topical steroids 22,24 and vitamin A administration,42 has been reported. 

REFERENCES

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2. Harrison PM. The annular erythemas.  Int J Dermatol 1979;18:282-90. 

3. Purdy MJ. Erythema gyratum repens. Arch Dermatol 1 959;80:590- 1. 

4. Schneeweiss J, Goid SC. Erythema gyratum repens. Proc Roy Soc Med 1959;52:367-8.

5. Duperrat B, Guilaine J, Demay C. Erythema gyratum: en rapport avec un carcinome cervical métastatique. Bulí Soc Franc Derm Syph 1961;68:20-1. 

6. Duperrat B, Pringuet R, David V. Erythema gyratum repens. Bulí Soc Franc Derm Syph 1961;68:578-82. 

7. Van Dijk E. Erythema gyratum repens. Dermatológica 1961;123:301-10. 

8. Storck H, Schnyder UW, Schwarz K. Erythema gyratum repens bei  hypopharynx carcinom. Dermatologica 1962;124:289-93. 

9. Caldwell 1W. In discussion of Church RE. Bronchiolar carcinoma  presenting as erythema gyratum perstans. Proc Roy Soc Med 1963;56:905. 

10. urch RE. Bronchiolar carcinoma presenting as erythema gyratum  perstans. Proc Roy Soc Med 1963;56:904-5. 

11. Woerdeman MJ. Erythema gyratum repens. Dermatológica 1964;128:391-2. 

12. Le Coulant P, Texier L, Maleville J, et al. Erythema gyratum repens. Buil Soc Franc Derm Syph 1966;73:235-6. 

13. Pevny 1. Erythema gyratum repens. Z Raut Geschlecbtslcr 1 966;40:26~70. 

14. Leavelí UW, Winternitz WW, Black JR. Erythema gyratum repens and undifferentiated carcinoma. Arch Dermatol 1967;95:69-72. 

15. Miguérés J, Jover A, Layssol M, et al. Un syndrome paranéoplasique rare: l'érythéme gyratum repens: Ses rapports avec le cancer bronchique. J Franc Med Chir Thor 1967;212:313-24.

16. Pokorny' M, Hilla M. Erythema gyratum repens. Cesk Dermatol 1969;44:200-3. 

17. Solomon R. Erythema gyratum repens [Letter]. Arch Dermatol 1969;lO0:639. 

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19. Thivolet J, Gallois P, Perrot R. Une dermatose paranéc> plasique  m6connue: l'érythema giratum repens. Rev Lyon Med 1970;19:789-95.  20. Thomson J, Stankler L. Erythema gyratum repens. Br J Dermatol 1970;82:406-1 1. 

21. Connor BL. Erythema gyratum repens: case presentation. Trans St Johns Hosp Dermatol Soc 1972;58:323-4. 2

2. Touraine R, Revaz J, Lepine J, et al. Syndrome paranéoplasique associant ichtyose généralisé et érythème annulaire. Bulí Soc Fr Derm Syph 1972;79:623-6. 

23. Saika NK, MacKie RM, McQueen A. A case of bullous pemphigoid and figurate erythema in association with metastatic spread of carcinoma.  Br J Dermatol 1973;88:33 1-4. 

24. Lukowska 1, Silny W. Erythema gyratum repens jako schorzenie paranowotworowe. Przegl Dermatol 1974; 61:785-9. 

25. Skolnick M, Mainman BR. Erythema gyratum repens with metastatic adenocarcinoma. Arch Dermatol  1975; 111:227-9. 

26. Holt PJA, Davies MG. Erythema gyratum repens an ímmunologically mediated dermatosis? Br J Dermatol 1 977;96:343-7. 

27. Verret JL, Pierrin B, Bertrand G, et al. Erythema gyratum repens: 011  syndrome paranéoplasique de Gammel. Ann Dermatol Venereol 1 977;104:403-6.

 28. Barber PV, Doyle L, Vickers DM, et al. Erythema gyratum repens with pulmonary tuberculosis. Br J Dermatol 1978; 98:465-8. 

29. Barriére H, Litoux P, Bureau B, et al. Erythema gyratum repens de Gammel et ichtyose acquise associés a un cancer de l'oesophage. Ann Dermatol Venereol 1978;105:3 19-21.

 30. Jacobs R, Eng AM, Solomon LM. Carcinoma of the breast, pemphigus vulgaris and gyrate erythema. mt J Dermatol 1978;17:221-4. 

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38. Yebra SI, Garciá BB, Camacho MF. Eritema gyratum re-pens de Gammel y enfirmedad de Hodgkin. Med Cutan Ibero Lat Am 1983;11:281-6.

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 44. Graham-Brown RAC. Bullous pemphigoid with figurate erythema associated with carcinoma of the bronchus. Br J Dermatol 1987;l 17:385-8. 

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59. Ludwig H, Mayr W. Genetic aspects of susceptibility to multiple  myeloma. Blood 1982;59:1286-91. 

60. Gupta RK, Morton DL. Tumor antigeos. In: Ray PK, ed. Immunobiology of  transpíantation, cancer and pregnancy. New York: Pergamon Press, 1983:113-47.

 61. Stone OJ. A mechanism of peripheral spread or localization of inflammatory reactions-role of the localized ground substance adaptive phenomenon. Med Hypotheses 1989; 29:167-9.

 62. Moore HJ. Does the pattern of erythema gyratum repens depend on a reaction-dilfusion system? [Lerter] Br J Der-matol 1982;107:723. 

63. Howel-Evans W, McConnell RB, Clarke DA, et al. Carci-noma of the esophagus with keratosis palmaris et plantaris (tylosis). Q J Med 1958;27:413-29. 

64. Richard M, Giroux J-M. Acrokeratosis paraneoplastic (Bazex syndrome). JAM ACAD DERMATOL 1987;16:178-83. 

65. Stone SP, Schrocter AL. Bulbus pemphigoid and associ-ated malignant  neoplasms. Arch Dermatol 1 975;1 11:991-4. 66. Kaplan RP, Callen JP. Pemphigus-associated diseases and induced  pemphigus. Clin Dermatol 1983; 1:42-71.  ============================================================= 

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2.) Cutaneous manifestations of cancer. 

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Curr Opin Oncol 1999 Mar;11(2):139-44 Related Articles, Books 

Sabir S, James WD, Schuchter LM 

Hematology-Oncology Division, Hospital of the University of Pennsylvania,  Philadelphia 19104, USA. 

The appearance of skin lesions in patients with occult or obvious  malignancy may be of extreme value in the detection and management of  cancer because the skin is readily accessible to examination and biopsy.  Examination of the skin of our patients can provide important insights into  underlying malignant processes or possible complications from cancer  treatment. The range of cutaneous abnormalities is wide, and include  cutaneous paraneoplastic syndromes such as xanthomas, acanthosis nigricans,  carcinoid syndrome, unusual erythematous eruptions such as erythema gyratum  repens, and a number of genetic syndromes associated with malignancies and  inherited dermatoses. 

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3.) Erythema gyratum repens in association with renal cell carcinoma. 

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J Urol 1998 Jun;159(6):2077 Related Articles, Books, LinkOut 

Kwatra A, McDonald RE, Corriere JN Jr 

Department of Surgery, University of Texas Medical School, Houston, USA. 

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4.) Erythema gyratum repens: another case of a rare disorder but no new insight into pathogenesis. 

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Dermatology 1996;193(4):336-7 Related Articles, Books 

Rojo Sanchez S, Suarez Fernandez R, de Eusebio Murillo E, Lopez Bran E,  Sanchez de Paz F, Robledo Aguilar A 

Department of Dermatology, Hospital Universitario San Carlos, Madrid, Spain. 

Erythema gyratum repens (EGR) is an uncommon but distinctive dermatosis  characterized by marble-like swirls of erythema and a thin covering scale  over the trunk, axillae and groins which has been associated with  malignancy. Bronchial carcinoma has been the most frequent neoplasm  associated. A case of EGR in a 50-year-old man with carcinoma of the lung  is reported. The onset of dermatosis preceded the discovery of the neoplasm  by 9 months. Oral corticosteroids induced the disappearance of the skin  lesions. No recurrence was observed after discontinuation of the treatment.  The patient died 1 year after the onset of dermatosis. 

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5.) Cutaneous paraneoplastic syndromes in solid tumors. 

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Am J Med 1995 Dec;99(6):662-71 Related Articles, Books 

Kurzrock R, Cohen PR 

Department of Clinical Investigation, University of Texas M.D. Anderson 

Cancer Center, Houston 77030, USA. 

OBJECTIVE: To provide an overview of the clinical manifestations,  pathophysiology, and oncologic implications of the cutaneous paraneoplastic  syndromes that occur predominantly in patients with solid tumors. METHODS:  A review was performed of the literature identified by a comprehensive  MEDLINE search. RESULTS: Diverse cutaneous paraneoplastic syndromes may be  associated with underlying tumors. They include musculoskeletal disorders  (clubbing, hypertrophic osteoarthropathy, dermatomyositis, and multicentric  reticulohistiocytosis), reactive erythemas (erythema gyratum repens and  necrolytic migratory erythema), vascular dermatoses (Trousseau's syndrome),  papulosquamous disorders (acanthosis nigricans, tripe palms, palmar  hyperkeratosis, acquired ichthyosis, pityriasis rotunda, Bazex's syndrome,  florid cutaneous papillomatosis, the sign of Leser-Trelat, and extramammary  Paget's disease), and disorders of hair growth (hypertrichosis lanuginosa  acquisita). The clinical manifestations of these dermatoses may precede,  coincide with, or follow the diagnosis of cancer. The presence of a  cutaneous paraneoplastic syndrome is often associated with a poor  prognosis. CONCLUSIONS: Cutaneous paraneoplastic syndromes are specific  constellations of mucous membrane and/or skin abnormalities that are caused  by an underlying tumor. Since they may be the presenting sign of an occult  cancer, cognizance of their features and clinical implications are of  considerable importance. Individuals with these syndromes should have a  thorough workup for an associated malignancy. 

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6.) Erythema gyratum repens unassociated with underlying malignancy. 

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J Dermatol 1995 Aug;22(8):587-9 Related Articles, Books 

Kawakami T, Saito R 

Second Department of Dermatology, Toho University School of Medicine, 

Tokyo, Japan. 

A case of erythema gyratum repens occurring in a 62-year-old woman is  presented together with a review of the literature. Evaluation and  follow-up for the development of malignancy over a 32-month period failed  to reveal any evidence of malignancy. Formerly, all cases of erythema  gyratum repens were evaluated in terms of an association with an underlying  malignant disorder. To date, only sixty cases have been reported in the  literature; 14 (23%) were not found to be associated with any neoplasm.  Therefore, this term is now also used for cases unassociated with  malignancy. Erythema gyratum repens is a cutaneous eruption with a  characteristic diagnostic morphology resembling a wood grain pattern. 

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7.) Erythema gyratum repens-like eruption in a patient with Sjogren syndrome. 

============================================================= 

Acta Derm Venereol 1995 Jul;75(4):327 Related Articles, Books 

Matsumura T, Kumakiri M, Sato-Matsumura KC, Ohkawara A 

Publication Types: 

Letter 

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8.) Paraneoplastic bullous pemphigoid resembling erythema gyratum repens. 

Br J Dermatol 1999 Mar;140(3):550-2 Related Articles, Books, LinkOut 

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Hauschild A, Swensson O, Christophers E 

Publication Types: 

Letter 

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9.) Eruption resembling erythema gyratum repens in linear IgA dermatosis. 

============================================================= 

Dermatology 1995;190(3):235-7 Related Articles, Books 

Caputo R, Bencini PL, Vigo GP, Berti E, Veraldi S 

Istituto di Scienze Dermatologiche, Universita di Milano, Ospedale 

Policlinico IRCCS, Italia. 

We report a case of linear IgA dermatosis associated with eruptions  resembling erythema gyratum repens in a 62-year-old man. The patient 

revealed no clinical and laboratory evidence of an underlying malignancy. 

The presence of eruptions similar to erythema gyratum repens during the 

course of bullous dermatoses has been described in only eight reports. 

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10.) Erythema gyratum repens associated with hypereosinophilic syndrome. 

============================================================= 

J Dermatol 1994 Aug;21(8):612-4 Related Articles, Books 

Morita A, Sakakibara N, Tsuji T 

Department of Dermatology, Nagoya City University Medical School, Japan. 

We report a case of typical erythema gyratum repens lesions observed as a  manifestation of idiopathic hypereosinophilic syndrome in a 63-year-old  man. While erythema gyratum repens is usually associated with malignancy,  an intensive search over a 30-month period failed to reveal any evidence of  neoplasm. With administration of dapsone, the typical gyrate lesions  disappeared as the subject's hypereosinophilia improved. 

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11.) Erythema gyratum repens. A case studied with immunofluorescence, 

immunoelectron microscopy and immunohistochemistry. 

============================================================= 

Br J Dermatol 1994 Jul;131(1):102-7 Related Articles, Books 

Caux F, Lebbe C, Thomine E, Benyahia B, Flageul B, Joly P, Rybojad M, Morel P 

Service de Dermatologie, Hopital Saint-Louis, Paris, France. 

We report a patient with erythema gyratum repens (EGR), in whom a bronchial  carcinoma was found. Direct immunofluorescence revealed granular deposits  of immunoglobulins at the basement membrane zone (BMZ) in the skin, and in  the lung tumour. Direct immunoelectron microscopy showed that the immune  deposits were localized just beneath the lamina densa. Indirect  immunofluorescence revealed circulating anti-BMZ antibodies.  Immunohistochemical staining, using anti-transforming growth factor-beta,  anti-epidermal growth factor receptor, anti-vimentin and anti-alpha-actin,  was found to be more intense in the lesional skin and the lung tumour than  in normal tissues. Possible mechanisms in the pathogenesis of EGR are  discussed. 

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12.) Erythema gyratum repens: direct immunofluorescence microscopic findings. 

============================================================= 

J Am Acad Dermatol 1993 Sep;29(3):493-4 Related Articles, Books, 

LinkOut 

Albers SE, Fenske NA, Glass LF 

Department of Internal Medicine, University of South Florida, College of 

Medicine. 

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13.) Erythema gyratum repens without underlying disease. 

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J Am Acad Dermatol 1993 Jan;28(1):132 Related Articles, Books, LinkOut 

Boyd AS, Neldner KH 

Publication Types: 

Comment 

Letter 

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14.)Reactive erythemas: erythema annulare centrifugum and erythema gyratum 

repens. 

============================================================= 

Clin Dermatol 1993 Jan-Mar;11(1):135-9 Related Articles, Books 

Tyring SK 

Department of Dermatology, University of Texas Medical Branch, Galveston. 

Publication Types: 

Review 

Review, tutorial 

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============================================================= 

15.) Subcorneal accumulation of Langerhans cells in erythema gyratum repens. 

============================================================= 

Br J Dermatol 1992 Feb;126(2):189-92 Related Articles, Books 

Wakeel RA, Ormerod AD, Sewell HF, White MI 

Department of Dermatology, Aberdeen Royal Infirmary, U.K. 

Erythema gyratum repens (EGR) is a cutaneous manifestation of malignant 

disease. We report an unusual accumulation of activated epidermal  Langerhans cells in the upper layer of the epidermis and propose that these  cells play an important immunopathological role. 

=============================================================  16.) Erythema gyratum repens in a healthy woman. 

============================================================= 

J Am Acad Dermatol 1992 Jan;26(1):121-2 Related Articles, Books 

Garrett SJ, Roenigk HH Jr 

Department of Dermatology, Northwestern University Medical School, Chicago, 

IL 60611. 

Comments: 

Comment in: J Am Acad Dermatol 1993 Jan;28(1):132 

============================================================= 

============================================================= 

17.) [Gammel's non-paraneoplastic erythema gyratum repens]. 

============================================================= 

Ann Dermatol Venereol 1991;118(6-7):469 Related Articles, Books 

[Article in French] 

Bazex J, Marguery MC 

Service de Dermatologie, Allergologie et Venereologie, Hopital Purpan, 

Toulouse. 

Publication Types: 

Review 

Review of reported cases 

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============================================================= 

18.) [Erythema gyratum repens type eruption]. 

============================================================= 

Ann Dermatol Venereol 1991;118(11):897-9 Related Articles, Books 

Goettmann S, Lazareth I, Crickx B, Lemaire V, Belaich S 

Service de Dermatologie, Hopital Bichat, Paris. 

============================================================= 

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19.) A mechanism of peripheral spread or localization of inflammatory 

reactions--role of the localized ground substance adaptive phenomenon. 

============================================================= 

Med Hypotheses 1989 Jul;29(3):167-9 Related Articles, Books 

Stone OJ 

It is known that connective tissue-active peptides (CTAP) are released at  sites of inflammation. Some of this material diffuses to immediately  adjacent tissue and increases ground substance viscosity and fibroblast  proliferation. This contributes to host protection against spread of  infections and tumors. In a person with normal inflammatory reactivity, it  should prevent spread of mediators and products of local inflammation.  However, the host with an increased reactivity in sites of increased ground  substance viscosity or who is highly reactive to dilution of tissue fluid  would respond with more inflammation. A non-infectious, non-malignant  process in a host with a highly reactive inflammatory or immune response  could end up with peripheral spread. This could occur in any tissue but it  occurs with great vigor in the skin. It could present as a peripheral  extension of a local disease process, such as psoriasis, or the migration  of cyclic lesions with clearing of the central area. There are over a dozen  variants of peripherally spreading, ringed lesions described in the  dermatologic literature. This includes erythema marginatum of rheumatic  fever, erythema gyratum repens associated with cancer, and erythema  annulare centrificum associated with allergic reactions to fungi. Many of  the ringed dermatologic lesions have an immunologic component. They tend to  be associated with inflammatory immune reactions at distant sites.  Dermatologists have been gathering information on the ringed phenomenon at  least since Hebra in 1854. The acute localized ground substance adaptive  phenomenon is a broadly beneficial biologic response. 

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20.) Episodic erythema gyratum repens with ichthyosis and palmoplantar 

hyperkeratosis without signs of internal malignancy. 

============================================================= 

Clin Exp Dermatol 1989 May;14(3):223-6 Related Articles, Books 

Juhlin L, Lacour JP, Larrouy JC, Baze PE, Ortonne JP 

Two patients with typical lesions of erythema gyratum repens, peripheral  ichthyosis, palmoplantar hyperkeratosis and nail changes are described. A  non-specific erythrodermic eruption of several weeks' duration had preceded  the typical lesions. No signs of internal malignancy were found and the  typical gyrate lesions disappeared within some weeks with full restitution  of all skin lesions within 6-8 months. 

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21.) Erythema gyratum repens. A cutaneous marker of malignancy. 

============================================================= 

Cancer 1988 Aug 1;62(3):548-50 Related Articles, Books 

Appell ML, Ward WQ, Tyring SK 

Department of Dermatology, University of Alabama, Birmingham. 

A patient with erythema gyratum repens in whom a bronchogenic carcinoma was  found is described. Erythema gyratum repens is a cutaneous eruption with a  unique morphology resembling a wood grain pattern. Its presence is almost  always associated with serious systemic pathology, usually neoplastic, and  thus should be considered a cutaneous marker of internal malignancy. 

============================================================= 

22.) Bullous pemphigoid with figurate erythema associated with carcinoma of the bronchus. 

============================================================= 

Br J Dermatol 1987 Sep;117(3):385-8 Related Articles, Books 

Graham-Brown RA 

Department of Dermatology, Leicester Royal Infirmary, Infirmary Square, U.K. 

A patient with bullous pemphigoid (BP), a figurate erythema resembling  erythema gyratum repens and a bronchial carcinoma is reported. It is  suggested that this is a genuine association and that when a figurate  erythema occurs with BP, an underlying carcinoma should be excluded. 

============================================================= 

23.) Erythema figuratum versus erythema gyratum repens. 

============================================================= 

J Am Acad Dermatol 1986 Jul;15(1):111-2 Related Articles, Books 

Ingber A, Sandbank M 

Publication Types: 

Letter 

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24.) Erythema gyratum repens, a stage in the resolution of pityriasis rubra 

pilaris? 

============================================================= 

Clin Exp Dermatol 1985 Sep;10(5):466-71 Related Articles, Books 

Cheesbrough MJ, Williamson DM 

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25.)[Erythema gyratum repens--a paraneoplastic dermatosis]. 

============================================================= 

Vestn Dermatol Venerol 1985 Aug;(8):49-51 Related Articles, Books 

[Article in Russian] 

Karalitskii EM 

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26.)Erythema gyratum repens unassociated with internal malignancy. 

============================================================= 

J Am Acad Dermatol 1985 May;12(5 Pt 2):911-3 Related Articles, Books 

Langlois JC, Shaw JM, Odland GF 

A case report of erythema gyratum repens occurring in a 68-year-old man is  presented. Evaluation and follow-up for development of malignancy over a  39-month period failed to reveal evidence of malignancy. The patient died  of an unrelated cause. Autopsy did not demonstrate any evidence of malignancy. 

============================================================= 

27.) Erythema gyratum repens. 

============================================================= 

Arch Dermatol 1985 Feb;121(2):170-1 Related Articles, Books 

Levine LE, Morgan NE, Fretzin D, Rubenstein D 

Publication Types: 

Letter 

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28.) Gyrate erythema. 

============================================================= 

Dermatol Clin 1985 Jan;3(1):129-39 Related Articles, Books 

White JW Jr 

The gyrate erythemas consist of a nonspecific group (often called erythema  annulare centrifugum) for which the cause is usually unknown, and three  specific types (erythema marginatum rheumaticum, erythema chronicum migrans  [Lyme disease], and erythema gyratum repens). The first specific type,  erythema marginatum rheumaticum, has become extremely rare with the decline  of its associated disease, rheumatic fever. The second specific type,  erythema chronicum migrans, is caused by a spirochete transmitted by the I.  ricinus complex of ticks. The third specific type, erythema gyratum repens,  is uncommon, morphologically distinctive, and an indicator of serious  disease, usually internal malignancy, in almost every instance. 

============================================================= 

29.) Infantile epidermodysplastic erythema gyratum responsive to imidazoles. A new entity? 

============================================================= 

Arch Dermatol 1984 Dec;120(12):1601-3 Related Articles, Books 

Saurat JH, Janin-Mercier A 

A 3 1/2-year-old girl had a three-year history of chronic annular erythema  that more closely mimicked erythema gyratum repens of adults than other  annular erythemas of infancy. Histopathologic study revealed bowenoid  characteristics in the epidermis. No fungi were ever demonstrated in this  patient's skin lesions, but they consistently responded to treatment with  ketoconazole and flared immediately after cessation of treatment with that  drug. 

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30.) Erythema gyratum repens with associated squamous cell carcinoma of the lung. 

============================================================= 

Cutis 1984 Oct;34(4):351-3, 355 Related Articles, Books 

Olsen TG, Milroy SK, Jones-Olsen S 

A 63-year-old man with erythema gyratum repens (EGR) was found to have an  underlying squamous cell carcinoma of the lung. Neither radiation nor  chemotherapy had any effect on the extensive eruption. EGR is the most  distinctive of the figurate erythemas, and continues to be one of the most  consistent cutaneous signs of an associated visceral malignancy. 

============================================================= 

31.) [Cutaneous paraneoplastic syndromes]. 

============================================================= 

Ann Med Interne (Paris) 1984;135(8):662-8 Related Articles, Books 

Barriere H 

The authors list the really significant paraneoplastic cutaneous syndromes:  acanthosis nigricans, paraneoplastic acrokeratosis, acquired ichthyosis  (and eventually the "explosive" onset of seborrheic warts) and a special  type of desquamative circinate erythema (erythema gyratum repens). The  possible paraneoplastic character of other conditions is also discussed:  dermatomyositis, necrosing vasculitis, autoimmune bullous conditions and  pruritus "sine materia". 

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32.) [Erythema gyratum repens and primary bronchial cancer. Disappearance of the dermatosis under general corticoid therapy]. 

============================================================= 

Ann Dermatol Venereol 1983;110(4):329-34 Related Articles, Books 

[Article in French] 

Larrouy JC, Apter J, Barety M, Ortonne JP 

A case of Erythema Gyratum Repens in a 76 year old man with bronchiolar  carcinoma is reported. The onset of the dermatosis preceded the discovery  of the neoplasm. Oral corticosteroids induced the disappearance of the skin  lesions. No recurrence was observed after discontinuation of the treatment.  The patient died 7 months after the onset of the dermatosis. 

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33.) [Erythema gyratum repens of Gammel and Hodgkin's disease]. 

============================================================= 

Med Cutan Ibero Lat Am 1983;11(4):281-6 Related Articles, Books 

[Article in Spanish] 

Yebra Sotillo I, Garcia Bravo B, Camacho Martinez F 

A 65 year old male with Hodgkins disease, and generalised figurate  Erythema, which during his period of hospitalisation migrated and became  much more evident, disappearing after initial therapy. Diagnosed as  "Erythema gyratum repens" reported by Gammel, an uncommon form of  paraneoplasic migrant figurate Erythema, we review the 33 previous cases of  this process, and find that, although 30 were related to other processes. 

============================================================= 

34.) Erythema gyratum repens-like figurate eruption in bullous pemphigoid. 

============================================================= 

Clin Exp Dermatol 1982 Jul;7(4):401-6 Related Articles, Books 

Breathnach SM, Wilkinson JD, Black MM 

============================================================= 

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35.) [Erythema gyratum repens]. 

============================================================= 

Ugeskr Laeger 1979 Dec 17;141(51):3532 Related Articles, Books 

[Article in Danish] 

Christensen JD 

============================================================= 

============================================================= 

36.) [Erythema gyratum repens]. 

============================================================= 

Hautarzt 1979 Apr;30(4):213-5 Related Articles, Books 

[Article in German] 

Verret JL, Schnitzler L, Schubert B, Alain YM, Bertrand G 

A case of erythema gyratum repens is reported in 78 year old woman. The  particularly typical eruption, mainly affecting the trunk, was associated  with a squamous cell carcinoma of the esophagus. The paraneoplastic  dermatosis cleared after radiotherapy of the cancer. 

============================================================= 

37.) Erythema gyratum repens: spontaneous resolution in a healthy man. 

============================================================= 

Br J Dermatol 1978 Oct;99(4):461 Related Articles, Books 

Stankler L 

Publication Types: 

Letter 

============================================================= 

============================================================= 

38.) Erythema gyratum repens with pulmonary tuberculosis. 

============================================================= 

Br J Dermatol 1978 Apr;98(4):465-8 Related Articles, Books 

Barber PV, Doyle L, Vickers DM, Hubbard H 

A 63-year-old man presented with erythema gyratum repens of 7 months'  duration. A cavitating mass at the right lung apex was resected and proved  to be tuberculous. Following the resection, the skin lesions cleared within  a few days. Erythema gyratum repens has not previously been described in  association with non-malignant visceral pathology. The pathogenesis remains  obscure but cannot be related specifically to a response to tumour cells or  their products in view of the association reported here. The condition  bears no resemblance to any known tuberculide. 

============================================================= 

39.) [Gammel's erythema gyratum repens and acquired ichthyosis associated with esophageal carcinoma]. 

============================================================= 

Ann Dermatol Venereol 1978 Mar;105(3):319-21 Related Articles, Books 

Barriere H, Litoux P, Bureau B, Preel JL, Thebaud Y 

============================================================= 

============================================================= 

40.) [Erythema gyratum repens or Gammel paraneoplastic syndrome. A case with 

epidermoid carcinoma developed on a megaesophagus]. 

============================================================= 

 Ann Dermatol Venereol 1977 May;104(5):403-6 Related Articles, Books 

[Article in French] 

Verret JL, Pierrin B, Bertrand G, Dubin J, Allain YM, Schnitzler L 

============================================================= 

============================================================= 

41.) Erythema gyratum repens--an immunologically mediated dermatosis? 

============================================================= 

 Br J Dermatol 1977 Apr;96(4):343-7 Related Articles, Books 

Holt PJ, Davies MG 

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============================================================= 

42.) Erythema gyratum repens with metastatic adenocarcinoma. 

============================================================= 

Arch Dermatol 1975 Feb;111(2):227-9 Related Articles, Books 

Skolnick M, Mainman ER 

A patient with Erythema Gyratum Repens (EGR) had a marked increase of his  eruption, with uncontrollable pruritus that was unresponsive to steriod  therapy. This culminated in an exfoliative dermatitis. A metastatic,  undifferentiated adenocarcinoma was removed following a right-sided  craniotomy. The patient then had complete cessation of his pruritus, with  moderate improvement of his eruption. All the reported cases of EGR were  reviewed in terms of the source of the malignant disorder. The relationship  between the time of onset of the EGR and the discovery of the malignant  disorder, as well as the effect of treatment of the malignant condition on  the course of the EGR, was studied. The data suggest a highly probable  relationship between the two. 

============================================================= 

43.) [Erythema gyratum repens (Gammel's syndrome)] 

============================================================= 

SO  - Hautarzt  1979 Apr;30(4):213-5 

AU  - Verret JL; Schnitzler L; Schubert B; Alain YM; Bertrand G 

PT  - JOURNAL ARTICLE 

AB  - A case of erythema gyratum repens is reported in 78 year old woman.  The particularly typical eruption, mainly affecting the trunk, was  associated with a squamous cell carcinoma of the esophagus. The  paraneoplastic dermatosis cleared after radiotherapy of the cancer. 

============================================================= 

44.) Figurate and bullous eruption in association with breast carcinoma. 

============================================================= 

SO  - Arch Dermatol  1990 May;126(5):649-52 

AU  - Watsky KL; Orlow SJ; Bolognia JL  PT  -

JOURNAL ARTICLE; REVIEW (16 references);

REVIEW OF REPORTED CASES  AB  -

We describe a patient with two coexistent cutaneous eruptions: (1)  trauma-induced bullae of the distal extremities and elbows and (2) multiple  concentric gyrate lesions on the trunk and extremities, some of which  became bullous. The gyrate lesions were stationary and nonpruritic. Biopsy  of both types of lesions showed a subepidermal blister and a minimal  inflammatory infiltrate. Direct immunofluorescence revealed linear  deposition of IgG and C3 at the dermoepidermal junction and indirect  immunofluorescence was negative. By immunoelectron microscopy, these immune  deposits were localized to the lower lamina lucida. The eruption was not  controlled despite high-dose (80 mg/d) oral administration of prednisone  and required the addition of an oral administration of methotrexate (20 mg  weekly). On further evaluation, an intraductal mammary carcinoma was  detected. Following radiation therapy, the methotrexate and prednisone  therapy were tapered without recurrence of the eruption during a follow-up  period of 18 months. 

============================================================= 

45.) [Erythema gyratum repens associated with bronchial carcinoma] 

============================================================= 

SO  - Hautarzt  1970 Mar;21(3):116-9 

AU  - Hochleitner H; Bartsch G; Zelger J 

PT  - JOURNAL ARTICLE 

============================================================= 

============================================================= 

46.) Erythema gyratum repens. Reports of two further cases associated with 

carcinoma. 

============================================================= 

SO  - Br J Dermatol  1970 Apr;82(4):406-11 

AU  - Thomson J; Stankler L 

PT  - JOURNAL ARTICLE 

============================================================= 

============================================================= 

47.) Carcinoma of the breast, pemphigus vulgaris and gyrate erythema. 

============================================================= 

SO  - Int J Dermatol  1978 Apr;17(3):221-4 

AU  - Jacobs R; Eng AM; Solomon LM 

PT  - JOURNAL ARTICLE 

============================================================= 

============================================================= 

48.) [Premycotic erythema simulating erythema gyratum repens]. 

============================================================= 

Bull Soc Fr Dermatol Syphiligr 1969;76(1):12 Related Articles, Books 

[Article in French] 

Duperrat B, Puissant A, Cherif-Cheikh JL, Pringuet R, David V, Blanchet P 

============================================================= 

============================================================= 

============================================================= 

49.) An unusual paraneoplastic syndrome: erythema "gyratum repens" or Gammel's syndrome]. 

============================================================= 

Presse Med 1967 May 20;75(24):1239-42 Related Articles, Books 

[Article in French] 

Migueres J, Jover A, Layssol M, Ranfaing J 

============================================================= 

============================================================= 

50.) [An unusual paraneoplastic syndrome: erythema gyratum repens. Its relation with bronchial cancer]. 

============================================================= 

J Fr Med Chir Thorac 1967 Apr;21(3):313-24 Related Articles, Books 

[Article in French] 

Migueres J, Jover A, Layssol M, Ranfaing J 

 

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DATA-MÉDICOS/DERMAGIC-EXPRESS No 2-(93)  19/04/2000 DR. JOSÉ LAPENTA R. 

UPDATED 07 AUGUST 2025

=================================================================== 

Produced by Dr. José Lapenta R. Dermatologist

Venezuela 1.998-2.025

Producido por Dr. José Lapenta R. Dermatólogo Venezuela 1.998-2.025

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