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

Author: Nat Pernick, M.D. (see Authors page)

Revised: 15 October 2018, last major update July 2011

Copyright: (c) 2002-2018,, Inc.

PubMed Search: Erythema elevatum diutinum

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Cite this page: Pernick, N. Erythema elevatum diutinum. website. Accessed January 19th, 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