• Annular, arciform, and polycyclic plaques due to infiltrates of lymphocytes within the dermis; lesions usually last for a few weeks to months and as they migrate centrifugally, there is central clearing; recurrences are common.

• This gyrate erythema is sometimes divided into superficial and deep forms, based on clinicopathologic findings, with the superficial form being minimally elevated with “trailing” white scale (Fig. 15.1A) and the deep form having a more infiltrated border (Fig. 15.1B); some authors reserve the designation EAC for the superficial form.

• Color varies from pink to darker red-violet, with the superficial form favoring the thighs and deeper the trunk; peak incidence is during the fifth decade.

• Often idiopathic, but some cases appear to be a reactive process triggered by fungal infections, in particular tinea pedis, or less often, viral infections or medications.

• DDx: Tinea corporis (especially if scale is present); if no surface changes, annular urticaria (Fig. 15.2), benign lymphocytic infiltrate (of Jessner), cutaneous lymphoid hyperplasia, cutaneous lupus erythematosus (tumidus), and lymphoma cutis as well as the other entities covered in this chapter and Table 15.1; in some patients, the diagnosis of EAC is rendered after exclusion of other disorders.

• Rx: if trigger identified, it should be treated; if no trigger is identified, topical CS may be of some benefit.

• Cutaneous manifestation of rheumatic fever (due to a preceding group A β-hemolytic streptococcal infection) and therefore seen more commonly in children.

• Migratory annular and polycyclic erythematous eruption that represents a major Jones criterion (Fig. 15.3

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