erythema nodosum syndrome

Question 1

inflammation or what skin layer

Answer 1

subcutaneous fat

Question 2

manif

Answer 2

EN is an important and common acute in ammatory/immunologic reaction pattern o the subcuta- neous at.
■ Characterized by the appearance o pain ul nodules on the lower legs.
■ Lesionsarebrightredand atbutnodularuponpalpation.
■ O ten ever and arthritis.

Pain ul, tender lesions, usually o a ew days’ duration, accompanied by ever, malaise, and arthralgia(50%),most requentlyo ankle joints. Other symptoms depending on etiology. SKIN LESIONS Indurated, very tender nodules (3 to 20 cm), not sharply marginated (Fig. 7-9), deep seated in the subcutaneous at, mostly
on the anterior lower legs, bilateral but not symmetric.Nodulesarebrighttodeepredand areappreciatedassuchonlyuponpalpation.

Question 3

age gender

Answer 3

T e most common type o panniculitis, with

a peak incidence at 20 to 30 years, but any age maybea ected.T reetosixtimesmorecom- monin emalesthaninmales

Question 4

labs

Answer 4

HEMATOLOGY Elevated ESR and C-reactive protein; leukocytosis.
BACTERIALCULTURE Culture throat or group A β-hemolyticstreptococcus,stool orYersinia. IMAGING Radiologic examination o the chest and gallium scan are important to rule out sarcoidosis.
DERMATOPATHOLOGY Acute (polymorpho- nuclear) and chronic (granulomatous)
in ammationinthesubcutis,aroundblood vesselsintheseptumandadjacent at.ENisa septal panniculitis

Question 5

tx

Answer 5

SYMPTOMATIC Bed rest or compressive ban- dages (lower legs), wet dressings. ANTI-INFLAMMATORYTREATMENT Salicylates, nonsteroidalanti-in ammatorydrugs. Systemic glucocorticoids—response is rapid, but their use is indicated only when the etiologyisknownandinectiousagentsare excluded.