Original Article

Erythema Marginatum and Hereditary Angioedema

Authors: John C. Starr ,MD, George W. Brasher, MD, Arundhati Rao, MD, Delma Posey, MD


Objective: To search for anaphylatoxin activity in plasma during episodes of erythema marginatum, and to evaluate the histology of erythema marginatum by electron microscopy and immunohistologic techniques.

Methods: Plasma samples were studied for C5a activity by granulocyte aggregation, and C3 conversion by immunoelectrophoresis. A skin biopsy of erythema marginatum was done, and the tissue stained with a rabbit antibody to bradykinin.

Results: No plasma anaphylatoxin was found. Dense deposits of bradykinin were discovered in stromal tissue and lining endothelial cells.

Conclusions: Bradykinin may be important in the causality of the erythema marginatum associated with hereditary angioedema.

Key Points

* Dermal manifestations of hereditary angioedema included angioedema and erythema marginatum.

* Bradykinin may be important in the etiology of hereditary angioedema.

* Bradykinin’s role in the erythema marginatum of hereditary angioedema is unknown.

* We have identified deposits of bradykinin in erythema marginatum of hereditary angioedema.

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