Successful combination therapy with dapsone and cyclosporine for erythema elevatum diutinum with unusual appearance

摘要

Erythema elevatum diutinum (EED) is a rare primary cutaneous vas-culitis of unknown etiology. The lesions are consisted with plaques and nodules with symmetrical distribution on the extensor surfaces of extremities. EED is often associated with various systemic and infectious diseases, such as multiple myeloma, lymphoma, para-proteinemia, rheumatoid arthritis, Crohn's disease, streptococcal, hepatitis B and HIV infections.We present a 75-year-old man who showed EED with an unusual distribution on the soles, fingers, trunk and feet accompanied with ulcerations. In May 2001, the patient was referred to Nemuro City Hospital with painful red papules and nodules over the fingers accompanied with marked nail deformities, and similar lesions on the trunk as well as verrucous plaques on the soles of 2-year duration (Fig. 1). Other physical examination was normal. No systemic disorders were noted except for diabetes mellitus.