Erythema Elevatum Diutinum

EED is a disease that looks neoplastic, but is inflammatory in nature.  Most of the primary lesions of EED are shiny, smooth papules or plaques that have the appearance of rubbed warts.  Unlike rheumatoid nodules they are mostly epidermal and dermal in appearance, as opposed to dermal and subcutaneous.  Primarily they are found over the hands and feet, knees and elbows.  

The classic histopathology of EED is a leukocytoclastic vasculitis. Attendant to the LCV is fibrosis which gives the EED papules their firm presentation.  

Associated diseases include HIV, IgA monoclonal gammopathy and other hematologic abnormalities, celiac disease, Wegener's, as well as chronic, recurrent strep infections.