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Erythema marginatum in Adult
Other Resources UpToDate PubMed

Erythema marginatum in Adult

Contributors: Christopher Iriarte MD, Susan Burgin MD
Other Resources UpToDate PubMed


Erythema marginatum is a distinctive reactive annular erythema most commonly associated with acute rheumatic fever secondary to streptococcal infection. It is typically found on the trunk and proximal extremities. It usually follows the onset of migratory arthritis, but it may occur months after carditis. Erythema marginatum is typically nonpruritic and overall asymptomatic. Approximately 10% of patients with acute rheumatic fever have the associated rash of erythema marginatum. It is observed more frequently in children than in adults. Erythema marginatum is one of the major Jones criteria, the set of criteria used to diagnose acute rheumatic fever.

Rarer conditions that have been associated with erythema marginatum include psittacosis and C1 esterase inhibitor deficiency (also known as hereditary angioedema). Of note, a case of hemorrhagic erythema marginatum was reported as a cutaneous toxicity to sorafenib in a patient undergoing treatment for hepatocellular carcinoma.


L53.2 – Erythema marginatum

50610002 – Erythema marginatum

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Urticaria
  • Urticarial vasculitis
  • Adult onset Still disease
  • Erythema multiforme
  • Mononucleosis
  • Erythema annulare centrifugum (familial annular erythema)
  • Erythema gyratum repens – faster moving
  • Erythema annulare centrifugum
  • Lyme disease

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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Last Reviewed:10/13/2020
Last Updated:10/13/2020
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Erythema marginatum in Adult
A medical illustration showing key findings of Erythema marginatum : Erythema, Thigh, Trunk, Upper arm, Blanching patch
Clinical image of Erythema marginatum - imageId=1120099. Click to open in gallery.  caption: 'A close-up of annular and gyrate erythematous plaques with faint surrounding pink-orange patches.'
A close-up of annular and gyrate erythematous plaques with faint surrounding pink-orange patches.
Copyright © 2024 VisualDx®. All rights reserved.