What Is Erythema Marginatum?


Erythema marginatum is an uncommon skin rash that can be found across the trunk and limbs. The rash is circular, with a pale pink center with a slight elevated outline of red. The rash may be seen in rings, or be more irregular and larger forms.

The rash isn’t a cause of disease by itself. Instead, it could be a sign of a underlying problem like:

  • rheumatic fever
  • the hereditary angioedema
  • Lyme disease
  • an allergic reaction

There are other kinds of rashes that are the erythema marginalatum. This includes:

  • Erythema migrans that tends to remain in one spot on the body
  • Lesions of erythema multiforme that can be spread throughout the body, appearing as crusty, raised patches
  • erythema annulare centrifugum may cause itching and scaling and can be visible on the face.

These rashes are linked with the word “erythema”, which means “red.” They each possess distinct features and causes that are distinct from each other.

Find out more about erythema marginatum.

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Identifying the erythema marginatum rash

The erythema marginatum rash may appear as a thin design on your skin that has an emerald-colored center with a flat or raised border of red. The overall shape may be semicircles or regular rings or less regular designs with Wavy margins.

Erythema marginatum fades fades out with time. It can be present only for a few hours or it may last for days or more. The rash doesn’t feel painful or itchy and may not be apparent on skin with darker tones.

Erythema marginatum is most often seen on the limbs and the trunk. It’s not often found on the face.

Image of the erythema marginatum


The causes of this rash

There are a variety of reasons that could cause an the erythema marginatum itchy rash.

Fever rheumatica

The most frequent cause of erythema is rheumatic disease. It’s found in 10-15% of those suffering from the illness. Other symptoms include:

  • fever
  • joint pain
  • nodules in the skin
  • heart valve damage
  • elevated C-reactive proteins in blood
  • Other skin eruptions

Rheumatic fever is a result of the strep throat that isn’t treated by antibiotics. It could cause severe heart problems. The condition is uncommon within the United States now, with an incidence in the range of 0.04-0.06 instances per 1000 Trusted Source children. Rheumatic disease and cardiovascular illness (RHD) can be more often diagnosed in developing countries. It is estimated that there are 15 million Trusted Source patients suffering from RHD across the globe.

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Hereditary angioedema

Erythema marginatum could be an early indication of angioedema hereditary. The rash is seen in 42-58 percent of children suffering from a form of hereditary angioedema, known as C1-INH-HAE. This includes newborns.

This rare , inherited disorder is seen in around one in 50,000 of us. The symptoms usually don’t show until puberty.

The erythema marginatum rash may be an important indicator of a possible attack. Sometimes, the rash can be often misdiagnosed as hives and delays the testing for angioedema.

Other symptoms are:

  • cramps
  • nausea
  • swelling of the hands, face arms, legs, and face
  • gastrointestinal problems
  • irritability
  • fatigue

Lyme disease

Rarely, erythema marginatum may be among the symptoms of skin that are associated with Lyme disease, but the erythema migrans type is more frequently encountered in this kind of disease.

Lyme is a chronic illness caused by Borrelia Burgdorferi bacteria through Blacklegged Deer Ticks. It’s difficult to determine due to its many symptoms are similar to those of other illnesses.

The symptoms include:

  • fatigue
  • achy, stiff, or swollen joints
  • headache dizziness, fever and many other signs of flu
  • Night sweats along with sleep issues
  • cognitive decline
  • Neurological issues


The adverse reaction to certain medications can cause an erythema marginatum rash. For example, the combination antibiotic amoxicillin-clavulanate (Augmentin) can cause erythema marginatum.

The diagnosis of the cause of erythema marginatum

When you notice that your kid suffers from an alopecia that resembles an erythema marginalatum, you should consult your doctor. The rash isn’t dangerous by itself, but it may indicate a more serious health issue.

Your doctor will inquire regarding your history with regards to medical conditions, any medications you take, as well as other signs and symptoms.

If you’ve had an episode of an episode of strep throat, your physician might recommend tests for blood to check for signs of rheumatic illness. Additionally, they may conduct tests to determine if you have suffered from heart problems. There is no single test that can diagnose rheumatic fever.

The doctor can also request blood tests if angioedema from an ancestor is suspected. The test will look for decreased C1 inhibitors which could be an indication of the condition.

Lyme is typically diagnosed based on symptoms and the results of a blood test.

The root causes for the skin rash

There’s no treatment available for erythema marginalatum. The rash disappears by itself. You might require treatment to treat an underlying issue that may be which is causing the rash.

The treatment for Rheumatic Fever is:

  • Antibiotics to treat infection
  • Salicylates are used to treat arthritis symptoms
  • corticosteroids to treat heart disease

Angioedema caused by an underlying cause is treated with C1 estrase inhibit (Cinryze) or Icatibant (Firazyr).

Lyme is treated by antibiotics.


The conditions that typically cause erythema marginatum are not common in the developed world which is why the rash isn’t as common within the United States. Similar rashes to other types are more frequent and could be confused with erythema margatum. It’s essential to visit your physician for a precise diagnosis.

The erythema marginatum rash will fade off on its own with time, and sometimes it takes hours. It may be a symptom of a variety of underlying diseases however, it is usually associated with it is a sign of rheumatic fever. If you’ve been diagnosed with angioedema, it is possible that the rash will occur again as a sign that you are experiencing an outbreak.

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