What Is Erythema Marginatum?

Rheumatic borderline erythema is the main symptom of rheumatic fever. There are two types of rheumatic skin lesions: one is flat, that is, ring-shaped rheumatoid erythema; the other is raised, that is, marginal erythema. The lesions are ring-shaped, arc-shaped, and can expand into a multi-ring or net-like shape. The damage spreads rapidly and can disappear within hours or days, but can occur repeatedly in batches elsewhere.

Basic Information

English name

erythema marginatum rheumaticum

Visiting department

Division of Rheumatology

Multiple groups

Patients with upper respiratory tract infections such as pharyngitis or tonsillitis in the first 1 to 5 weeks

Common locations

Torso, especially abdomen, followed by limbs

Common causes

Group A hemolytic streptococcal infection

Common symptoms

Fatigue, loss of appetite, irritability, fever, arthritis, myocarditis, subcutaneous nodules, circular erythema, and chorea

Causes of rheumatic borderline erythema

Rheumatic borderline erythema is associated with group A hemolytic streptococcal infection. The mechanism of group A streptococcus-induced rheumatic fever is not fully understood, but it is not caused by direct infection with streptococcus. The group A streptococcus cell wall contains a layer of protein, consisting of three proteins, M, T and R, of which the M protein is the most important. It can block phagocytosis and is the basis of bacterial typing, also known as "cross-reactive antigen". Rheumatoid erythema or marginal erythema can occur when the body produces cross-reactive antigens.

Clinical manifestations of rheumatic borderline erythema

Most patients have a history of upper respiratory infections such as pharyngitis or tonsillitis 1 to 5 weeks before the onset of disease. When he became ill, he was tired, lost appetite, and irritable. The main clinical manifestations are fever, arthritis, myocarditis, subcutaneous nodules, annular erythema, and chorea. Skin lesions are more common in the trunk, especially the abdomen, followed by limbs, and the face and hands are rare. Diagnosis can be made based on the skin lesions being raised.

Rheumatic borderline erythema

Laboratory inspections found that anti-O and ESR increased.

Differential diagnosis of rheumatic borderline erythema

Should be distinguished from annular rheumatoid erythema. The annular rheumatoid erythema is flat and has no bulge.

Rheumatic marginal erythema complications

Rheumatic borderline erythema can be complicated by myocarditis and arthritis.

Rheumatic borderline erythema treatment

Non-steroidal anti-inflammatory drugs and salicylate preparations can be used for anti-rheumatic therapy, and antibiotics such as penicillin can be used at the same time. If necessary, glucocorticoids can be applied.

Prognosis of rheumatic borderline erythema

It can occur repeatedly for weeks to months without subjective discomfort.

Rheumatoid borderline erythema prevention

Prospective long-term follow-up studies have found that recurrence of rheumatic fever only occurs after re-infection with streptococcus. Prompt antibacterial treatment and prevention of streptococcal infections can prevent the onset and recurrence of the disease.