Erythema elevatum diutinum coexisting with ankylosing spondylitis

Area of Science:

• Dermatology
• Rheumatology
• Pathology

Background:

• Ankylosing spondylitis is a chronic inflammatory disease primarily affecting the spine.
• Erythema elevatum diutinum (EED) is a rare, chronic vasculitis characterized by skin lesions.
• The coexistence of EED and ankylosing spondylitis is exceptionally uncommon, with limited documented cases.

Purpose of the Study:

• To report the first known case of Erythema elevatum diutinum (EED) in a patient with a history of ankylosing spondylitis.
• To describe the clinical presentation, histopathological findings, and successful treatment of this rare co-occurrence.

Main Methods:

• A case study of a 43-year-old female patient with a known diagnosis of ankylosing spondylitis.
• Clinical examination revealed characteristic reddish-purple nodules on the extremities.
• Skin biopsy analysis showed specific inflammatory cell infiltration and erythrocyte extravasation.

Main Results:

• The patient presented with a distinct reddish-purple rash and nodules on the forearms, legs, and hands.
• Histopathology confirmed features consistent with Erythema elevatum diutinum (EED).
• Treatment with sulphasalazine, colchicine, and diclofenac resulted in complete healing of lesions within 3 months.

Conclusions:

• This case highlights the first documented instance of Erythema elevatum diutinum (EED) associated with ankylosing spondylitis.
• The findings suggest a potential, albeit rare, link between these two conditions.
• Prompt diagnosis and multi-drug therapy can effectively manage EED in patients with underlying spondyloarthropathies.