Paraneoplastic Erythema Annulare Centrifugum Eruption (PEACE) Associated With Metastatic Colorectal Adenocarcinoma

Erythema annulare centrifugum (EAC) is a figurate erythema presenting with annular, erythematous plaques with a trailing scale. It is considered a hypersensitivity reaction to a variety of antigens and is associated with multiple underlying causes including malignancy. Malignancy-associated EAC is t...

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Bibliographic Details
Published inCurēus (Palo Alto, CA) Vol. 13; no. 10
Main Authors Pitchford, Chase A, R. Shenk, Mary E, Zurowski, Susan, Smith, Emily H
Format Journal Article
LanguageEnglish
Published Palo Alto Cureus Inc 02.10.2021
Cureus
Subjects
Allergy/Immunology
Autoimmune diseases
Biopsy
Cancer
Case reports
Cytokeratin
Dermatitis
Dermatology
Erythema
Medical screening
Metastasis
Oncology
Tumors
Vertebrae
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Summary:Erythema annulare centrifugum (EAC) is a figurate erythema presenting with annular, erythematous plaques with a trailing scale. It is considered a hypersensitivity reaction to a variety of antigens and is associated with multiple underlying causes including malignancy. Malignancy-associated EAC is termed paraneoplastic erythema annulare centrifugum eruption (PEACE). Although a specific etiology has yet to be elucidated, this form of EAC is likely to occur due to cytokine and/or antigen stimulation from an underlying malignancy. PEACE is primarily associated with lymphoproliferative disorders and rarely solid tumors. Our report discusses a case of PEACE associated with metastatic colorectal adenocarcinoma. On presentation to our clinic, the patient had developed a migratory annular eruption over a year. His review of symptoms was positive for signs of underlying malignancy, including weight loss and recent lower vertebral fracture. A biopsy of his annular lesion revealed a non-specific pityriasiform dermatitis. A vertebral biopsy uncovered a diagnosis of metastatic colorectal cancer. At that time, clinicopathologic correlation allowed us to reach the diagnosis of PEACE.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.18443