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Erythema Nodosum (EN)
Published in Charles Theisler, Adjuvant Medical Care, 2023
Erythema nodosum is a skin condition that causes painful swollen red or purple bumps most commonly on the shins. Young women ages 15–30 are five times more likely than men to develop erythema nodosum. Inflammation of the subcutaneous fat causes tender red lumps or nodules of erythema nodosum that range in size from a dime to a quarter. They may be inflamed off and on for a period of weeks, then shrink and become flat, leaving a bruised appearance. This condition is the most common form of panniculitis, or inflammation of the fat layer underneath the skin. EN can develop on its own or in association with certain medical conditions (e.g., sarcoidosis, TB, IBD, etc.) and medications (e.g., penicillin, oral contraceptives with estrogen, salicylates, etc.). Erythema nodosum can go away on its own in three to six weeks. Chronic erythema nodosum is a condition in which additional lesions pop up in different locations for a period of weeks to months or may last for years.1
Lower legs
Published in Richard Ashton, Barbara Leppard, Differential Diagnosis in Dermatology, 2021
Richard Ashton, Barbara Leppard
Common causes of erythema nodosum: Drugs, e.g. sulphonamides and the oral contraceptive pill.Pregnancy.Streptococcal sore throat.Sarcoidosis.Ulcerative colitis.Crohn's disease.Tuberculosis.Numerous other viral, bacterial and fungal infections.
Clinical Manifestations and Histological Characteristics
Published in Kirsti Kauppinen, Kristiina Alanko, Matti Hannuksela, Howard Maibach, Skin Reactions to Drugs, 2020
Kirsti Kauppinen, Arja-Leena Kariniemi
EN lesions are tender erythematous nodules that are distributed symmetrically on the extensor surfaces of the lower extremities and cause marked edema. In more severe cases they may also be located on the thighs and arms. General symptoms such as fever, malaise, and arthritis are unusual in cases of drug-induced erythema nodosum. The onset is rapid but the regression occurs slowly.
Oncoplastic Breast Surgery Techniques When Surgery is Essential for the Management of the Idiopatic Granulomatous Mastitis
Published in Journal of Investigative Surgery, 2022
Ahmet Dağ, Akay Edizsoy, Mustafa Berkeşoğlu
Between 2016 and 2020, 20 female patients diagnosed with IGM underwent surgery. Of these 20 patients, 18 patients who underwent wide excision with OBS techniques were included in the study. Two patients who benefited from debridement and abscess drainage were excluded from the study. All patients were of reproductive age and the average age of these patients was approximately 34.2 years (range: 25–42 years). All patients had a history of at least one delivery, with an average of 2.1 (1–4). Fifteen patients had breastfed for an average of 16 months (range: 3–36 months). Three patients had problems with breastfeeding because of nipple problems, and two patients could breastfeed only for 3 months. Four patients (22.2%) had a history of OCU of at least 6 months. Nine patients (50%) were smokers, and two patients (11.1%) had a history of diabetes mellitus. None of the patients had a history of tuberculosis. Only two patients had a family history of tuberculosis. Two patients (11.1%) had a history of erythema nodosum. Rheumatologic tests were negative, and prolactin levels were normal in all the patients. Tissue culture, ARB, and PCR examinations of the patients also showed no signs of tuberculosis. Two patients (11.1%) were diagnosed with FNAB; 14 (77.8%) with ultrasound-guided tru-cut; and two (11.1%) with abscess drainage. Two patients had a history of excision. Steroids were prescribed to 15 patients for at least 8 weeks (mean 11.5 weeks) after the diagnosis of GM. Three of these patients (16.7%) received methotrexate treatment because of steroid-related side effects (Tables 1 and 2).
Clinical phenotypes of Behçet’s syndrome in a large cohort of Italian patients: focus on gender differences
Published in Scandinavian Journal of Rheumatology, 2021
P Leccese, MC Padula, N Lascaro, AA Padula, S D’Angelo
Our results on clinical manifestations are summarized in Table 1. Mucocutaneous involvement was the most common manifestation, followed by ocular lesions, fever, and arthralgia. According to ISG criteria, all patients included in the study had oral aphthosis. Although the difference was not statistically significant, genital ulcers were a more frequent manifestation in females (65.0% in females vs 56.6% in males). The frequency of folliculitis was slightly higher in males (19.1%) than in females (15.4%), while a comparable frequency was found for pathergy (7.1% vs 6.8%, respectively). Statistically significant gender-related differences were recognized for papulopustolar lesions, which were more frequent in males (p < 0.01, OR 5.83). Erythema nodosum was more frequent in females than in males (p < 0.01, OR 0.48).
The ocular involvement did not accompany with the genital ulcer or the gastrointestinal symptoms at the early stage of Behçet’s disease
Published in Modern Rheumatology, 2019
Akiko Suwa, Nobuyuki Horita, Takehito Ishido, Masaki Takeuchi, Tatsukata Kawagoe, Etsuko Shibuya, Takahiro Yamane, Takahiko Hayashi, Akira Meguro, Mizuho Ishido, Kaoru Minegishi, Ryusuke Yoshimi, Yohei Kirino, Shingo Kato, Jun Arimoto, Takeshi Fukumoto, Yoshiaki Ishigatsubo, Michiko Kurosawa, Takeshi Kaneko, Mitsuhiro Takeno, Nobuhisa Mizuki
Oral ulceration was diagnosed based on recurrent well-defined shallow aphthous oral ulcers that may appear on oral mucosa including labial mucosa, buccal mucosa, tongue, and gingiva. Skin lesions were diagnosed based on erythema nodosum typically appearing in the lower limbs; hypocutaneous thrombophlebitis; folliculitis and acne typically appearing on the face, neck, and back. Ocular lesions were diagnosed based on bilateral uveitis with episodic attack of conjunctival congestion, ophthalmalgia, decreased visual acuity, and visual field deficit. Genital ulceration was diagnosed based on well-defined painful aphthous ulcer typically appearing on the scrotum and penis of a male and the labia major and labia minor of a female. More detailed description of each manifestation is available elsewhere [21].