Erythema elevatum diutinum and plastic surgery

Abstract.

Erythema elevatum diutinum (EED) is a chronic form of leucocytoclastic vasculitis that presents with symmetrical plaques, papules, and nodules in an acral distribution. The treatment is conservative, with dapsone being the first choice among the drugs commonly used. However, the late lesions may not respond due to the marked fibrosis, and they are extremely stressful to the patient both symptomatically and cosmetically. A case of EED in a patient with history of splenectomy for idiopathic thrombocytopenic purpura (ITP) is presented, where the late cutaneous lesions were excised and skin grafted. The association with splenectomy and the use of skin grafting as a mode of treatment when all other modalities have failed, have not been reported previously. A review of the relevant literature is presented.