Erythema Elevatum Diutinum: An Underdiagnosed EntityA Case Report

Erythema Elevatum Diutinum (EED), an uncommon form of chronic leukocytoclastic vasculitis presents as reddish-brown plaques and papulonodules primarily affecting the extensor surface. It mimics various cutaneous disorders and hence poses diagnostic difficulties. EED is predominantly seen in middle-aged individuals between fourth and sixth decade. EED can also have various extracutaneous manifestations such as arthralgia, scleritis, panuveitis, ulcerative keratitis and neuropathy indicating circulating immune complexes deposition in several organs. Thereby thorough clinical and systemic examination for early diagnosis and comprehensive management of both skin and extracutaneous findings are essential to prevent complications and further progression. The authors hereby report a case of 47-year-old female with long standing diabetes mellitus presenting with asymptomatic papulonodular lesions over the extensor surface with sensory abnormalities, highlighting the diagnostic dilemma and emphasising the importance of histopathological correlation in arriving at appropriate diagnosis.