Erythema nodosum (EN) seems to occur in children more rarely than in adults. It still remains the most frequent acute panniculitis, for which the diagnosis is almost always clinical. In a retrospective study of 27 pediatric patients, we have attempted to clarify the clinical spectrum and prognosis of this disease and discuss the differential diagnosis of nodular eruptions on the lower limbs of children. In almost half the patients of our series, the cause of EN remained undetermined. Streptococcal infections (usually of the pharynx) were the most common cause of EN in children (22% of patients in our series), followed by Yersinia infection in about 15% of patients. Tuberculosis, an important cause in the past, was never found, but must always be excluded. A benign course was noted in all patients. Erythema nodosum is easily recognized clinically, but other subcutaneous lesions, especially nodular vasculitis and Schönlein-Henoch purpura, have to be excluded by pathologic study, in cases of atypical presentation or long duration.

8 children aged 1 to 13 years, clinically suspected of having contact dermatitis due to footwear, have been studied in our Paediatric Dermatology Unit from January 1980 to September 1995. Patch tests have been performed with the European standard series and with constituents of the patients' own shoes. In our study, patients appeared to be predominantly sensitive to rubber chemicals. Avoiding shoes or materials that had been identified improved the symptoms in most cases.

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This report describes the case of a patient with a 14-month course of severe oligoarthritis associated with acne. Pure cultures of Propionibacterium acnes were isolated from synovial tissue and synovial fluid specimens collected from the same joint after a 4-month interval. After 2 months of treatment with roxithromycin 300 mglday, rifampicin 1,200 mglday, and a nonsteroidal antiinflammatory drug (NSAID), followed by 4 months of treatment with azithromycin 1 gm/week and an NSAID, the synovitis persisted. Cultures of skin lesions and synovial fluid at this time were negative.Although P acnes has previously been isolated from bone specimens obtained from patients with osteitis associated with acne, this is the first report of the isolation of this microorganism from the synovial tissue of a patient with arthritis associated with acne. Our findings raise the question of the role of P acnes in the pathogenesis of arthritis associated with acne.Acne is a chronic inflammatory disease of the pilosebaceous follicles, characterized by the formation of comedones and erythematous papules and pustules, and less frequently, by nodules or cysts and ulcerative lesions that can lead to definitive scarring. Acne can be differentiated into acne vulgaris (thc common form that begins classically in thc prepubertal period and resolves by the mid-20s; significant lesions can still bc sccn in 3%