Clinical presentation of erythema nodosum

Szczęch, Justyna; Matławska, Monika; Rutka, Maja; Reich, Adam

doi:10.25121/pnm.2018.31.1a.25

Cited by 5 publications

(3 citation statements)

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“…It is characterized by the sudden development of painful erythematous nodules and plaques on the extensor surfaces of the lower limbs. Recurrences are rare, and the lesions typically resolve on their own without scarring, necrosis, or atrophy [7,8]. The typical presentation of erythema nodosum includes the abrupt appearance of nodules and raised plaques on the lower legs.…”

Section: Resultsmentioning

confidence: 99%

Untitled

2023

J. Med. Chem. Sci.

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Background: Erythema nodosum (EN) is the most common form of septal panniculitis resulting from a hypersensitivity reaction in response to numerous antigens or triggers. Case: A 43-year-old female presented with a chief complaint of erythematous painful non-ulcerating nodules on the lower limbs for 18 months. This was preceded by a painful, erythematous rash consisting of a few subcutaneous nodules on both limbs. A dermatological examination of the tibia region revealed multiple tender erythematous and hyperpigmented nodules. A biopsy and serology test were performed to rule out differential diagnoses. Based on the data, the working diagnosis is erythema nodosum caused by trichomoniasis and vulvovaginal candidiasis. We managed this case with metronidazole 500 mg twice daily for seven days, fluconazole 150 mg as a single dose, and non-steroidal antiinflammatory drugs. One week after receiving treatment, her pain complaint disappeared, but the hyperpigmented macules still persisted, although they had decreased. One year after treatment, the patient's complaints did not recur. Discussion: EN may be associated with a wide variety of disease processes, and its observation should be followed by finding the underlying etiology. The clinical presentation includes symmetrical, tender, erythematous, warm nodules, and raised plaques usually located on the shins, ankles, and knees. The lesions show spontaneous regression without ulceration, scarring, or atrophy, and recurrent episodes are uncommon. The EN diagnosis is based on clinical presentation and histopathological findings. Conclusion:The management of erythema nodosum involves identifying the etiologic factor and focusing on eliminating exposure or treating the underlying diseases.

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Section: Resultsmentioning

confidence: 99%

Untitled

2023

J. Med. Chem. Sci.

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“…Panniculitides can originate either as primary pathologies within AT or as secondary manifestations of systemic diseases. For instance, erythema nodosum (EN), the most common type of panniculitis, may be idiopathic or triggered by infections, sarcoidosis, Crohn's disease, or other conditions (142). In rare cases, neutrophilic dermatoses or pregnancy can induce an EN eruption (143).…”

Section: Sat In Inflammatory Skin Diseasesmentioning

confidence: 99%

Subcutaneous Adipose Tissue: Implications in Dermatological Diseases and Beyond

Ziadlou,

Pandian,

Hafner

et al. 2024

Preprint

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Subcutaneous adipose tissue (SAT) is the deepest component of the three-layered cutaneous integument. While mesenteric adipose tissue-based immune processes have gained recognition in the context of the metabolic syndrome, SAT has been traditionally considered primarily for energy storage, with less attention to its immune functions. SAT harbors a reservoir of immune and stromal cells that significantly impact metabolic and immunologic processes not only in the skin, but even on a systemic level. These processes include wound healing, cutaneous and systemic infections, immunometabolic and autoimmune diseases, inflammatory skin diseases, as well as neoplastic conditions. A better understanding of SAT immune functions in different processes, could open avenues for novel therapeutic interventions. Targeting SAT may not only address SAT-specific diseases but also offer potential treatments for cutaneous or even systemic conditions. This review aims to provide a comprehensive overview on SAT’s structure and functions, highlight recent advancements in understanding its role in both homeostatic and pathological conditions within and beyond the skin, and discuss the main questions for future research in the field.

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“…Whereas the majority of EN cases are idiopathic, EN can also be associated with a systemic infection, or, less commonly, autoimmune / inflammatory conditions such as sarcoidosis and inflammatory bowel disease (13)(14)(15)(16). Histopathologically, EN is characterized by a mostly septal lymphocytic infiltrate (17). It has been hypothesized that type III or IV hypersensitivity reactions are involved in the pathogenesis of EN (5,18,19), but there is scarce experimental evidence supporting this (20,21).…”

Section: Introductionmentioning

confidence: 99%

Spatial mapping of subcutaneous adipose tissue microenviounment in panniculitis: Unveiling novel immune signatures

Brüggen,

Ziadlou,

Ameri

et al. 2023

Preprint

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Panniculitis, characterized by inflammation of the subcutaneous adipose tissue, displays diverse clinical and dermatohistopathological phenotypes. However, the underlying pathomechanisms remain largely unknown, with limited studies pointing to a delayed-type III/IV hypersensitivity reaction. In the present study, we aimed to gain new insights into the pathogenesis of the two most common panniculitis subtypes, erythema nodosum (EN) and erythema induratum (EI), by exploring their cellular and molecular immune patterns. We analyzed deep lesional skin biopsies from EN and EI patients (n=16 per group) and healthy controls (n=6) using imaging mass cytometry (IMC) to map the leukocytic infiltrate. The IMC analysis revealed distinct cellular profiles for EN and EI. In both conditions, macrophages were the predominant immune cell type, exhibiting a shift towards an M1 phenotype compared to healthy controls. In EI, the M1 macrophages were particularly prominent and were noted to cluster with activated CD8+ T cells. Conversely, EN showed fewer inflammatory features and a larger B cell population. These cellular changes were supported by an overall strong type 1 immune signature on the mRNA level in both EN and EI. This was evidenced by the upregulation of NLR-, NFkB-, and inflammasome-signaling-pathway genes compared to healthy controls. The type 1 signature was more pronounced in EI than in EN. These findings challenge the current understanding of panniculitis. They point towards a key role of M1 macrophages in mediating both innate and adaptive immune responses in panniculitis.

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Clinical presentation of erythema nodosum

Cited by 5 publications

References 0 publications

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Subcutaneous Adipose Tissue: Implications in Dermatological Diseases and Beyond

Spatial mapping of subcutaneous adipose tissue microenviounment in panniculitis: Unveiling novel immune signatures

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