Image in medicine
Paraneoplastic erythema annulare centrifugum eruption (PEACE)
Eritema anular centrífugo paraneoplásico (PEACE)
Javier Aubán Pariente
, Borja Gómez Vila, Beatriz Vázquez Losada, Jorge Santos-Juanes
Corresponding author
Dermatology Department, Central University Hospital of Asturias, Oviedo, Spain
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Physical examination revealed multiple, 2-to-20-cm, oval, annular and polycyclic plaques with nonscaling erythematous indurated edges on both upper and lower extremities (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). A skin biopsy of one plaque was consistent with a deep form of erythema annulare centrifugum (EAC). Laboratory investigations including complete blood count, serum chemistry profile, antinuclear antibodies, Lyme titer and cultures for fungi were within normal limits. Urinalysis revealed microscopic hematuria. Abdominal computed tomography showed a hypervascular, exophytic, heterogeneous mass on the upper pole of the left kidney (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>). A pathological examination confirmed a clear cell renal cell carcinoma. Skin lesions gradually resolved within several weeks after urological surgery and a diagnosis of paraneoplastic EAC eruption (PEACE) was made.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">EAC is a figurate erythema which is considered as a delayed-type hypersensitivity reaction to a wide variety of antigens. This entity has been associated with infections, drugs, endocrine disorders and occult malignancies, including lymphoproliferative and solid tumors. 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