Erythema Marginatum

Erythema Marginatum: Causes, Picture, Symptoms and Treatment

Skin problems like Erythema Marginatum are one of the skin issues that can cause you discomfort. The different skin issues can give you the sleepless night. It can make you think about the underlying cause leading to immense stress. So, let’s delve deep into the skin issue to help you necessary steps to overcome the issue.

Types Of Erythema

Before going into the Erythema Marginatum, you need to understand the root issue. It is known as Erythema. The term erythema refers to the redness of mucous membranes or the skin. It is mainly caused due to the increased blood flow (also known as hyperemia) in your shallow capillaries. You can experience the issue mainly due to inflammation, infection or skin injuries. It is also caused by other issues like the radiotherapy treatment, use of acne medications, etc. It is classified into several different types. Each type has different symptoms. Hence, it requires a different treatment plan to overcome the issue. The main types of Erythema are:

Erythema Multiforme (EM)

It is the most common form that can affect people. It occurs due to the allergic reaction you may develop from taking medication or suffer from infections.

Erythema Induratum

People with tuberculosis can suffer from the issue.

Erythema Nodosum (EN)

As the name suggests it can cause a nodular eruption. So, you may see it mostly on your lower legs. It has specific symptoms that help you identify the disease. You may experience the following:

  • Low-grade fever
  • Weight loss
  • Pain in joints (with/without arthritis)
  • Uneasy feeling
  • A cough

Erythema Chronicum Migrans

It is an issue that requires immediate medical attention. It points to the underlying issue of Lyme’s disease. So, you need to take it as the warning that points towards the early stages of the disease.

Erythema Ab Inge

It is the type of erythema that affects people exposed to the heat continuously for a long time.

Erythema Infectiosum

It is the most common type or redness that affects children. The problem is commonly known as the fifth disease. So, you may have experienced it in your childhood.

Erythema Marginatum

It is the type that the article focusses on. It is mostly characterized by the pink/red rings that you may get on our limbs.

Palmar Erythema

It has specific characteristics that make it easy to identify the type. So, you may see the skin on your palms of your hands become red in color.

Erythema Annulare Centrifugum

It is the condition detected in early 1900 (1916 by Darier). The centrifugum in the word means center and the term annulare refers to a ring. So, you can see red rings that can spread from the center.

What Is Erythema Marginatum?

The term Erythema in Greek actually means redness. It is one of the types of Erythema. So, your skin can become red in color due to the skin rash or other conditions. It is a rare type of skin rash caused by allergic reaction or infection. Therefore, you may experience mild skin rash or deal with life-threatening emergency depending on the steps you take.

Appearance Of Erythema Marginatum

Are you confused about the rashes you can see on your skin? Then, you need to know about the appearance of Erythema. It will help you detect the presence of erythema and take necessary action. Is the rash having a round appearance? The pale-pink center along with the raised outline red in color points to erythema. It may have rings like appearance with larger, elongated or regular shapes.

Appearance Of Erythema Marginatum

In most cases, the rash causes no itching or pain. It also does not appear on face or feet soles that you check regularly. So, you may not detect the presence of the rash for some time. As the rash may appear on the trunks or limbs. It can lead you to ignore it completely. But, it is a serious condition that can result in developing rheumatic fever. Hence, you need to maintain caution. If you see any rashes with a clear center, then take action immediately. Therefore, you can avoid fatality with the prompt and swift action.

Why You Need To Maintain Caution?

The rash itself is not a disease. But, it points to some underlying medical condition that needs immediate medical assistance. So, you need to look out for other diseases like:

  • Lyme Disease
  • Rheumatic Fever
  • Hereditary Angioedema
  • Allergic Reactions

Signs Of Erythema Marginatum

With the different types of erythema, you need to distinguish with signs. So, the erythema marginatum has the following signs you need to check out:


Signs Of Erythema Marginatum

It may appear a faint pattern on your skin with a pinkish center. So, the overall appearance looks like semi-circles or regular rings with flat or raised border. It may also appear as regular shapes with the curvy or wavy margins. The red rash has elevated regular margins and a clear center. It generally starts in the trunk area. Then, it spreads to the other parts of your body like the limbs. But, it does not appear on your face, palms of your hands or your feet.

Duration Of The Rash

The rash may fade out as the time passes. The red rash can appear for a few hours or for some days. It can even last longer. Sometimes it goes away by just pressing it on for a few minutes.

Size Of The Rash

The exact size of the rash varies in diameter from 0.5 cm-1 cm. It can develop after you suffer from fever. You may not notice the rash as it is small in size. But, as it spreads to different parts of the body, you may panic.

Accompanying Symptoms

It is not characterized by any pain or itching like other rashes. You can experience the rash in hot weather. It goes away once the weather turns cool. So, the rashes can play hide and seek (appear and disappear) occasionally. The situation can continue for several weeks or months.

Main Causes Of Erythema Marginatum

The skin disorder mainly affects the light-skinned people. The male population is more prone to the issue compared to the female. Several underlying diseases cause the rash.

Rheumatic Fever

Rheumatic Fever The erythema marginatum is found in 10-25% of the rheumatic fever cases. It is the most common cause of the rash. If you have rheumatic fever, you may experience other symptoms like:

  • Fever
  • Skin Rashes
  • Heart valve damage
  • Nodules under the skin
  • The high levels of protein (C-reactive) in blood

When the strep throat is not treated properly, it can escalate to rheumatic fever. So, you need to take the antibiotic prescribed by your doctor. Failing to take the antibiotics can lead to heart damage or other severe complication. By getting rheumatic fever, you can increase the chances of getting affected by the bacterium (streptococcus pyrogens). So, it can cause the inflammation in your body. It affects not just your skin, but also heart, brain, and joints. The bacterium is also responsible for the ring-shaped rashes that spread throughout the body. The macules can take the snake-like appearance on your skin. It can lead to severe mental stress. As the fever increases, the intensity of the rashes also escalates.

Hereditary Angioedema

Hereditary angioedema is a rare disease that can affect children. The infants or even newborns can get affected by the disease. Some children may never see the symptoms until they reach puberty. The common symptoms of the issue are:

The erythema marginatum rash also appears as symptoms for the rare disease. It is the first warning sign that something is wrong. But, most times the rash is misdiagnosed as hives. Hence, it results in getting adequate medical attention at the right time. It is important to note the symptoms and get proper care.

Hormonal Changes

The change in the hormones in your body is also responsible for the rashes. So, pregnant women can experience the skin disorder. But, it goes away on its own after the delivery of the baby. Children hitting the puberty can also see the issue on their body. A huge transformation occurs in the body and mind during teenage years. It is due to hormonal changes. Hence, the erythema marginatum is a common occurrence.


Some of the life threatening condition can show erythema marginatum as one of the symptoms. So, people suffering from the following issues can see the skin disorder:


Some infections in your body can also cause the skin disorder. Mycoplasma or Herpes virus (HSV) can cause the skin disorder. The presence of the following can lead to the skin disorder.

  • Escherichia Coli
  • Ascaris Lumbricoid
  • Candida Albicans

It can result in the reddish eruptions on your skin.

Lyme Disease

Lyme disease can show some skin symptoms that serve as the warning sign for you. So, you can see the erythema marginatum on your skin. Naturally, your next question is about the Lyme disease. It is the disease that is caused by the bacterium (Borrelia burgdoferi). So, the bacterium is transmitted via the ticks found in blacklegged deer into humans. The disease shows a wide variety of symptoms. Hence, it makes the diagnosis difficult. You may experience signs like:

  • Swollen Joints
  • The decline of cognitive powers
  • A headache
  • Fever of dizziness
  • Flu-like symptoms
  • Stiff and achy joints
  • Sleep disturbances
  • Neurological issues
  • Night sweats

Allergic Reaction

Your body can experience side-effects due to taking certain drugs. The adverse effects include erythema marginatum. So, the following medication can cause the issues:

  • Penicillin
  • Antibiotics
  • Phenytoin
  • Sulfonamides
  • Barbiturates

Complications Caused By Erythema Marginatum

The dermal condition in itself never causes you any issues. But, the underlying health problems can seriously affect you. If you have the skin disorder due to some diseases like rheumatic fever, then you need treatment. Ignoring the disease can lead to other severe complications like Polyarthritis, subcutaneous nodules, myocarditis, and Sydenham’s chorea. Hence, you can risk your life by not getting the necessary treatment.

Diagnosing The Underlying Cause Of The Skin Disorder

The rash is not serious by itself. But, it signifies a health problem that needs immediate medical attention. So, if you see rashes on your body, get immediate medical advice. Your doctor may perform the following to get to the root of the problem:

Understand The Medical History

Your doctor may perform the physical examination of our skin. It helps determine the problem causing the skin disorder. Your doctor will also understand the medical history of the patient. It will help your doctor understand the associated disorder or the allergy due to drug use.


The presence of cancerous cells in your body can cause the skin problem. Therefore, your doctor may order for a skin biopsy to find the presence of cutaneous disorder. A small section of the skin gets checked in the lab to detect the cancerous existence.


An infection can lead to the erythema margiatum. Therefore, your doctor may order a swab culture. It gets checked in the lab to detect the presence of microorganisms.

Check For Rheumatic Fever

Rheumatic fever is the main reason for getting the skin disorder. So, your doctor may perform the following tests:

  • Order a complete blood count test for evaluation.
  • The lab takes the throat for detecting the presence of streptococcus pyogenes (bacteria causing strep throat).
  • The Electrocardiogram detects the heart functioning. So, the Electrocardiogram can show any improper function.

Allergy To Drugs

Since the symptoms of the skin order mimic that of the hives, your doctor may check drug reaction. It helps your doctor detect the drug that causes the skin problem.

Prevention Of Erythema Marginatum

You need to understand that erythema marginatum is not a disease. It is the main symptom of a more serious disease. So, you need to treat the underlying condition to heal the skin problem. Once you get rid of the health problem, the skin issue heals by itself. You can prevent the skin issue by treating the disease causing it.

  • You need to identify the disease causing the problem to get the necessary treatment. The dermal issue is not fatal in itself. But, the disease may cause complication. Therefore, seek medical help immediately.
  • With long-term antibiotic treatment, you can prevent Rheumatic feve. So, it will avoid the macular rings formation on our skin.
  • Seek medical treatment for strep throat immediately. It will help you get the necessary medical assistance. Ignoring it will lead to a severe complication that can prove severe.

Treatment Of Erythema Marginatum

The rash itself needs no medical intervention. With the treatment of the disease causing the skin problem, it fades on its own. The different conditions are treated in the following ways:

Lyme disease

Your doctor may prescribe antibiotics to eliminate the problem completely. By taking the prescribed course completely, you can alleviate the issue. So, it will eradicate the skin problem completely.

Inherited Angioedema

The two treatment options are:

  • Treating with Cinryze (C1 esterse inhibitor)
  • Firazyr (Icatibant)

Rheumatic fever

The diverse symptoms associated with the disease gets treated in the following methods:

  • Infection- Take antibiotics
  • Arthritic Symptoms- Saliclates for easing the problems
  • Heart Complications- Take Corticosteroids


You need to maintain caution with erythema marginatum. The skin problems point to some other health issue that can cause complications in your life. You can also confuse the rash with the other types of rashes. So, it is ideal to take the necessary steps without delay. At times, the rash may fade without medical help. But, it is advised to get your doctor’s advice before coming to any conclusion.

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