Erythema annulare centrifugum (EAC) is an annular, erythematous lesion that appears as urticarial-like papules and enlarges centrifugally, then clears centrally. A fine scale is sometimes present inside the advancing edge, known as a trailing scale. Erythema annulare centrifugum is classified as a reactive erythema and has been associated with various underlying conditions, including malignancies. When erythema annulare centrifugum occurs as a paraneoplastic phenomenon, it has been designated PEACE (paraneoplastic erythema annulare centrifugum eruption). PEACE is more commonly seen in females, typically precedes the clinical diagnosis of malignancy, and may recur with subsequent relapses. EAC is one of the three major figurate erythemas, with EAC being the most common. These dermatoses share the common presentation of advancing erythematous, annular lesions, but are each separated by unique clinical and histopathologic characteristics. Once the other major figurate erythemas (erythema marginatum, erythema migrans, and erythema gyratum repens) are excluded, EAC often becomes a diagnosis of exclusion.
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