Erythema nodosum as a manifestation of many systemic diseases
DOI:
https://doi.org/10.12775/JEHS.2023.35.01.002Keywords
erythema nodosum, streptococcal infection, tuberculosis, sarcoidosis, behçet's disease, inflammatory bowel diseaseAbstract
Introduction and purpose: Erythema nodosum is a most frequent form of panniculitis and it appears as erythematous, painful rounded, nodules typically localized on the pretibial area. The purpose of our review is to present diseases that can be underlying causes of erythema nodosum and to draw attention to accompanying symptoms that can guide us to the appropriate diagnosis.
Brief description of the state of knowledge: Currently, erythema nodosum is thought to be a symptom associated with hypersensitivity reactions to various antigens. Although the majority of the causes are considered idiopathic, erythema nodosum may be caused by many etiological factors.
Summary: Erythema nodosum is usually an acute condition that resolves without treatment. However, it can sometimes be the first sign of a serious condition - autoimmune diseases, infections or malignancy. In such cases it is essential to observe it carefully and implement appropriate diagnostics that allow us to make a correct diagnosis.
References
Leung AKC, Leong KF, Lam JM. Erythema nodosum. World J Pediatr. 2018 Dec;14(6):548-554. doi: 10.1007/s12519-018-0191-1. Epub 2018 Sep 29. PMID: 30269303.
Trapani S, Rubino C, Lodi L, Resti M, Indolfi G. Erythema Nodosum in Children: A Narrative Review and a Practical Approach. Children (Basel). 2022 Apr 4;9(4):511. doi: 10.3390/children9040511. PMID: 35455555; PMCID: PMC9025345.
Blake T, Manahan M, Rodins K. Erythema nodosum - a review of an uncommon panniculitis. Dermatol Online J. 2014 Apr 16;20(4):22376. PMID: 24746312. doi: 10.5070/D3204022376.
Ozbagcivan O, Akarsu S, Avci C, Inci BB, Fetil E. Examination of the Microbial Spectrum in the Etiology of Erythema Nodosum: A Retrospective Descriptive Study. J Immunol Res. 2017;2017:8139591. doi: 10.1155/2017/8139591. Epub 2017 May 28. PMID: 28634591; PMCID: PMC5467334.
Min MS, Fischer R, Fournier JB. Unilateral Erythema Nodosum following Norethindrone Acetate, Ethinyl Estradiol, and Ferrous Fumarate Combination Therapy. Case Rep Obstet Gynecol. 2016;2016:5726416. doi: 10.1155/2016/5726416. Epub 2016 Mar 27. PMID: 27110414; PMCID: PMC4826688.
Xu X, Liang G, Duan M, Zhang L. Acute myeloid leukemia presenting as erythema nodosum: A case report. Medicine (Baltimore). 2017 Nov;96(47):e8666. doi: 10.1097/MD.0000000000008666. PMID: 29381943; PMCID: PMC5708942.
Potempa, Magdalena & Sedlaczek, Katarzyna & Jonczyk, Paweł. (2018). Erythema nodosum – one symptom, many causes?. Pediatria i Medycyna Rodzinna. 14. 381-385. doi:10.15557/PiMR.2018.004.
Pérez-Garza DM, Chavez-Alvarez S, Ocampo-Candiani J, Gomez-Flores M. Erythema Nodosum: A Practical Approach and Diagnostic Algorithm. Am J Clin Dermatol. 2021 May;22(3):367-378. doi: 10.1007/s40257-021-00592-w. Epub 2021 Mar 8. PMID: 33683567; PMCID: PMC7938036.
Requena L, Sánchez Yus E. Erythema nodosum. Semin Cutan Med Surg. 2007 Jun;26(2):114-25. doi: 10.1016/j.sder.2007.02.009. PMID: 17544964.
Shulman ST, Bisno AL, Clegg HW, Gerber MA, Kaplan EL, Lee G, Martin JM, Van Beneden C; Infectious Diseases Society of America. Clinical practice guideline for the diagnosis and management of group A streptococcal pharyngitis: 2012 update by the Infectious Diseases Society of America. Clin Infect Dis. 2012 Nov 15;55(10):e86-102. doi: 10.1093/cid/cis629. Epub 2012 Sep 9. Erratum in: Clin Infect Dis. 2014 May;58(10):1496. Dosage error in article text. PMID: 22965026; PMCID: PMC7108032.
Rizvi Z, Iqbal T, Javed A, Rizvi A. Erythema Nodosum: A Consequence of Tuberculosis. Cureus. 2019 May 23;11(5):e4724. doi: 10.7759/cureus.4724. PMID: 31355084; PMCID: PMC6650172.
Bjorn-Mortensen K, Ladefoged K, Simonsen J, Michelsen SW, Sørensen HC, Koch A, Lillebaek T, Andersen AB, Soborg B. Erythema nodosum and the risk of tuberculosis in a high incidence setting. Int J Circumpolar Health. 2016 Oct 25;75:32666. doi: 10.3402/ijch.v75.32666. PMID: 27784508; PMCID: PMC5081485.
Jain R, Yadav D, Puranik N, Guleria R, Jin JO. Sarcoidosis: Causes, Diagnosis, Clinical Features, and Treatments. J Clin Med. 2020 Apr 10;9(4):1081. doi: 10.3390/jcm9041081. PMID: 32290254; PMCID: PMC7230978.
Caplan A, Rosenbach M, Imadojemu S. Cutaneous Sarcoidosis. Semin Respir Crit Care Med. 2020 Oct;41(5):689-699. doi: 10.1055/s-0040-1713130. Epub 2020 Jun 27. PMID: 32593176.
Saadoun D, Wechsler B. Behçet's disease. Orphanet J Rare Dis. 2012 Apr 12;7:20. doi: 10.1186/1750-1172-7-20. PMID: 22497990; PMCID: PMC3472229.
Esatoglu SN, Kutlubay Z, Ucar D, Hatemi I, Uygunoglu U, Siva A, Hatemi G. Behçet's syndrome: providing integrated care. J Multidiscip Healthc. 2017 Aug 14;10:309-319. doi: 10.2147/JMDH.S93681. PMID: 28860798; PMCID: PMC5565245.
Bulur I, Onder M. Behçet disease: New aspects. Clin Dermatol. 2017 Sep-Oct;35(5):421-434. doi: 10.1016/j.clindermatol.2017.06.004. Epub 2017 Jun 27. PMID: 28916023.
Greuter T, Vavricka SR. Extraintestinal manifestations in inflammatory bowel disease - epidemiology, genetics, and pathogenesis. Expert Rev Gastroenterol Hepatol. 2019 Apr;13(4):307-317. doi: 10.1080/17474124.2019.1574569. Epub 2019 Feb 20. PMID: 30791773.
Rogler G, Singh A, Kavanaugh A, Rubin DT. Extraintestinal Manifestations of Inflammatory Bowel Disease: Current Concepts, Treatment, and Implications for Disease Management. Gastroenterology. 2021 Oct;161(4):1118-1132. doi: 10.1053/j.gastro.2021.07.042. Epub 2021 Aug 3. PMID: 34358489; PMCID: PMC8564770.
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Copyright (c) 2023 Dominika Kojder, Weronika Pawlak, Julia Szymańska, Lena Musiał, Agnieszka Możdżyńska, Kamil Kapłon, Izabela Kamińska, Anna Rymarz, Paulina Frączek, Mirosław Sołtys
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