Erythema marginatum is described as the presence of pink rings on the trunk and inner surfaces of the limbs which come and go for as long as several months. It is found primarily on extensor surfaces.

An association with bradykinin

Bradykinin

Bradykinin is a peptide that causes blood vessels to dilate , and therefore causes blood pressure to lower. A class of drugs called ACE inhibitors, which are used to lower blood pressure, increase bradykinin further lowering blood pressure...

 has been proposed in the case of hereditary angioedema.

Presentation

The rings are barely raised and are non-pruritic. The face is generally spared.

Associated conditions

It occurs in less than 5% of patients with rheumatic fever

Rheumatic fever

Rheumatic fever is an inflammatory disease that occurs following a Streptococcus pyogenes infection, such as strep throat or scarlet fever. Believed to be caused by antibody cross-reactivity that can involve the heart, joints, skin, and brain, the illness typically develops two to three weeks after...

, but is considered a major Jones criterion when it does occur. The four other major criteria include carditis, polyarthritis, Sydenham's Chorea

Sydenham's chorea

Sydenham's chorea or chorea minor is a disease characterized by rapid, uncoordinated jerking movements affecting primarily the face, feet and hands. Sydenham's chorea results from childhood infection with Group A beta-hemolytic Streptococci and is reported to occur in 20-30% of patients with...

, and subcutaneous nodules. In this case, it is often associated with Group A streptococcal infection

Group A streptococcal infection

The group A streptococcus bacterium is a form of β-hemolytic Streptococcus bacteria responsible for most cases of streptococcal illness. Other types may also cause infection...

.

It is an early feature of rheumatic fever

Rheumatic fever

Rheumatic fever is an inflammatory disease that occurs following a Streptococcus pyogenes infection, such as strep throat or scarlet fever. Believed to be caused by antibody cross-reactivity that can involve the heart, joints, skin, and brain, the illness typically develops two to three weeks after...

 and may be associated with mild carditis

Carditis

Carditis is the inflammation of the heart or its surroundings.It is usually studied and treated by specifying it as:*Pericarditis is the inflammation of the pericardium*Myocarditis is the inflammation of the heart muscle...

(inflammation of heart muscle).

Types

Some sources distinguish between the following:

• "Erythema marginatum rheumaticum"
• "Erythema marginatum perstans"

External links

• Photo
• Health Pictures - "Erythema Annulare Centrifugum" ("Erythema marginatum perstans")