Skin inflammatory (nontumor)
Dermal perivascular and vasculopathic reaction patterns
Erythema elevatum diutinum

Topic Completed: 1 July 2011

Revised: 27 March 2019

Copyright: 2002-2019,, Inc.

PubMed Search: Erythema elevatum diutinum

Nat Pernick, M.D.
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Page views in 2019 to date: 1,295
Cite this page: Pernick N Erythema elevatum diutinum. website. Accessed August 18th, 2019.
Definition / general
  • Bilaterally symmetric erythematous or violaceous plaques or nodules, often over outer surface of joints
  • Systemically ill patients or associated with HIV
  • May be related to granuloma faciale
  • May be an immune-complex vasculitis induced by chronic antigen exposure
Case reports
Clinical images

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Firm brown tumors on extensor surfaces of extremities

Gross images

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Nodules removed from hand

Microscopic (histologic) description
  • Leukocytoclastic vasculitis, progressing to fibrosis and onion skinning around vessels
  • Extracellular lipid deposits may be present in late lesions; no / rare eosinophils
Microscopic (histologic) images

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Small vessel vasculitis

Whorled fibromatous pattern

Differential diagnosis
  • Localized chronic fibrosing vasculitis: different clinical findings
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