Erythema marginatum is a rash that can appear in some cases of rheumatic fever, particularly in children. It consists of circular patches that spread outward in a slightly raised red ring pattern. Treatment involves addressing the underlying rheumatic fever, and patients should seek medical evaluation if they notice the rash along with joint pain and fever.
Erythema marginatum is a characteristic rash seen in some cases of rheumatic fever, in which people develop widespread inflammation following a strep infection. The rash can be an important diagnostic clue, as well as a warning, and tends to be more likely in children than adults. It consists of a series of circular patches along the torso and the inside of the extremities. The rash does not itch or burn and can be difficult to spot in people with dark skin, as the characteristic redness may be hidden by their natural skin pigmentation.
In erythema marginatum, the rash begins as a patch and grows outward in a circular pattern. As the rash spreads, the center tends to lighten. This creates a series of slightly raised red rings. Some of them can be quite large. Usually the face and the outer parts of the extremities, such as the hands and front of the legs, will not develop the rash. Patients will notice that it tends to redden in response to heat, such as after a shower or in very hot weather.
Treatment of erythema marginatum requires addressing the underlying rheumatic fever. Antibiotics are available to kill the bacteria, and patients may also be given anti-inflammatory drugs. Patients can also sometimes benefit from applying soothing creams and other preparations to the skin to reduce the swelling and redness of the rash. Simply applying a moisturizer after a shower can be very helpful in reducing skin irritation and minimizing the appearance of the rash.
The erythema marginatum rash is a symptom, rather than a primary disease, and treatment will focus on the source of the rash rather than the rash itself. It can persist for months in some patients, even after rheumatic fever has been addressed. Treating rheumatic fever is important, as it can damage the heart and lead to heart problems later in life. Patients who are not treated can die from injury to the heart muscle caused by inflammation.
People who notice erythema marginatum along with joint pain and fever should be evaluated for rheumatic fever, especially if they have a recent history of strep infection. The sooner treatment is provided, the more effective it will be. Prompt treatment also prevents some of the complications of the disease and can help patients enjoy longer and healthier lives after recovering from rheumatic fever.
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