Recurrent acute appendicitis with erythema annulare centrifugum

Erythema annulare centrifugum (EAC), a chronic figurate eruption, occurred in a 28-year-old male physician several months following the onset of recurrent abdominal pain. Two months after the manifestation of EAC, another episode of abdominal pain culminated in appendectomy for perforated appendicitis. During his convalescence, the skin lesions faded and did not reappear. We propose that recurrent appendiceal inflammation caused both the episodic pain and the skin eruptions. Additionally EAC may be a sign of chronic infection, internal malignancy, or food allergy. Although truly chronic appendicitis is a disputed entity, recurrent, spontaneously resolving episodes of appendicitis occasionally do precede surgical appendicitis. The presence of EAC in a patient having recurrent abdominal pain should discourage a precipitant diagnosis of functional illness and prompt further investigation.