Reactions 1704, p173 - 2 Jun 2018 Neutrophilic figurate erythema A 35-year-old man developed neutrophilic figurate erythema (NFE) following treatment with anti-oxidant herbal medicine contacting ginkgo biloba [route and dosage not stated]. The man presented with relapsing, reddish, mildly pruritic and edematous swellings on the pre-sternal area, shoulders, trunk and upper extremities for eight months. One month prior to presentation, he received treatment with anti-oxidant herbal pills containing ginkgo biloba on his own. The lesions would aggravated after cold exposure and would resolve spontaneously after rise in body temperature. Dermatological examination demonstrated firm, erythematous, non-tender, polimorphic plaques in annular and semi-annular or polycyclic – – configurations, measuring in 0.5 2cm x 0.5 2cm size on his shoulders, chest and back. Histopathological examination of the punch biopsy showed a perivascular and interstitial eosinophil, neutrophil and lymphocytic infiltration with swelling and proliferation of the endothelial cells in the dermis. Nuclear dusts were absent. Patch test with ginkgo biloba was negative. Based on the findings, a diagnosis of NFE was made, which was considered to be related to ginkgo biloba. The man’s treatment with ginkgo biloba was discontinued and he was treated with colchicine and levocetirizine for three months. The lesions improved. The man’s treatment with ginkgo biloba was restarted for two weeks. However, ten days following reintroduction, he again developed the same lesions. His treatment with ginkgo biloba was discontinued and the lesions resolved. At one year follow-up, he was asymptomatic. Author comment: "We consider our case to represent a figurate erythema with a dominant infiltration of neutrophils that might be also induced by Ginkgo biloba." Ustuner P, et al. Cold induced neutrophilic figurate erythema. Turkiye Klinikleri Dermatoloji 27: 117-121, No. 3, 18 Dec 2017. Available from: URL: http:// doi.org/10.5336/dermato.2016-53745 - Turkey 803322944 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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