Erythema marginatum is described as the presence of pink rings on the trunk and inner surfaces of the arms and legs which come and go for as long as several months. The rings are barely raised and are non-pruritic. The face is generally spared.
It occurs in less than 5% of patients with rheumatic fever and sometimes called erythema marginatum rheumatica , but is considered a major Jones criterion when it does occur.
It is an early feature of rheumatic fever and may be associated with mild carditis.
Epidemiology
In developed countries, rheumatic fever has become very rare and this rash occurs in no more than 2 to 5% of cases of rheumatic fever. However, rheumatic fever has become as common in New Zealand as in some developing countries, especially amongst the Maori children. In the 1990s there appeared to be a resurgence of rheumatic fever in the USA. Erythema marginatum was uncommon in patients with rheumatic fever reported in a large series from Pittsburgh.