Transcript erythema nodosum - Dr. Raj Kumar Sharma

ERYTHEMA NODOSUM
• DEFINITION-THIS IS A REACTVE DERMATOSIS THAT
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OCCERS IN RESPONSE TO A MYRIAD OF CONDITION
CHARACTERISED BY TENDER, ERYTHEMATOOUS
SUB CUTANEOUS NODULES PRIMARILY AFFECTING THE
LOWER EXTREMITIES
MOST COMMEN TYPE OF PANNICULITIS
AGE 20 TO 30 YEARS BUT ANY AGE GROUP MAY BE
AFFECTED
FEMALE:MALE 3-6 :1
ETIOLOGICAL AGENTS
• BACTERIAL• STREPTOCOCCAL INFECTION,
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TUBERCULOSIS,YERSINIOSIS,BRUCELLOSIS,SALMONELL
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FUNGAL INFECTION –
COCCIDIOIDOMYCOSIS,BLASTOMYCOSIS,HISTOPLASMO
SIS, DERMATOPHTOSIS
VIRAL INFECTION– INFECTIOUS MONONUCLEOSIS,
ORF, HEPATITIS-B HERPES SIMPLEX
PARASITIC INFESTATION - AMEBIASIS, GIARDIASIS,
DRUGS – SULFONAMIDES,BROMIDES,IODIDES,ORAL
CONTRACEPTIVE, MINOCYCLINE,SALISYLATES
MALIGNANCIES – HODGKIN’S, NON HODGKIN;S
LYMPHOMAS
SARCOIDOSIS
INFLAMMATORY BOWEL DISEASE,ULCERATIVE
COLITIS,CRON’S DISEASE,BECET’S DISEASE
CLINICAL PRESENTATON
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SUDDEN ONSET
SYMMETRICAL
PAINFUL
ERYTHEMATOUS
WARM
NONULCERATED NODULES/PLAQUES
KNEES, SHINS,FEET
MAY BE AT THIGHS,ARMS, & FACE
UNDERGO COLOUR CHANGES AS ADVANCE IN THE
DURATION
RESOLVE WITHOUT SCARRING OR ATROPHY
ASSOCIATED WITH PYREXIA,MALAISE, HEADACHE
ARTHRALGIAS
RECURRENT EPISODES ARE KNOWN
ERYTHEMA NODOSUM
ERYTHEMA NODOSUM
HISTOPATHOLOGY
• SEPTAL PANICULITIS WITHOUT VASCULITIS
TREATMENT
• TREATMENT OF UNDERLYING DISEASE
• SPONTANEOUSLY RESOLVES
• NONSTEROIDAL ANTI-INFLAMMATORY
AGENTS- ASPIRIN, INDOMETHACINE,NAPROXEN
• ORAL POTASSIUM IODIDE 400 TO 800 MG/DAY
• ORAL PREDNISONE