Erythema elevatum diutinum (EED) is a chronic cutaneous disease characterized by nodules and plaques in an acral and symmetrical location. Histologically, the earliest findings are a vasculitis in the dermis associated with an inflammatory-cell infiltrate and a tinctorial change in the vessel wall and adjacent perivascular fibers. The histologic findings are thought to be highly characteristic. Extracellular cholesterosis (EC) most likely represents a variant in which lipids are secondarily deposited between the collagen bundles. The earlier division of EED into the Hutchinson and Bury types is no longer thought to be warranted.
A patient is presented with clinical and histological features of EED; an elevation of several amino acids in the urine with essentially normal plasma levels was revealed.
Elevations of IgG and IgA, and a mild elevation in leukocyte alkaline phosphatase were present.
Mraz JP, Newcomer VD. Erythema Elevatum DiutinumPresentation of a Case and Evaluation of Laboratory and Immunological Status. Arch Dermatol. 1967;96(3):235-246. doi:10.1001/archderm.1967.01610030013003