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Results for “ERYTHEMA NODOSUM”

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At least 55 records · Page 3Linked to original sources
PubMed1992

Immune complexes and antibody levels in blisters over human leprosy skin lesions with or without erythema nodosum leprosum.

Erythema nodosum leprosum (ENL) is a serious complication of lepromatous leprosy, affecting skin and peripheral nerves in a large percentage of these patients, and is presumed to result from spontaneous immunologic changes. Its pathogenesis is poorly understood, although histopathologic features have suggested immune complex (IC)-mediated injury. Abundant circulating antibody is present but no convincing correlation has been established between circulating IC and ENL. We have examined cutaneous leprosy lesions in vivo using blisters induced by prolonged gentle suction to determine whether or not IC are demonstrable in lesions with or without ENL, using an IC assay based on monoclonal rheumatoid factor binding. We also examined whether antibodies involved in such IC are produced locally or reach the skin via the circulation. Surprisingly large quantities of IC were found in ENL lesions, and in some cases the quantities were significantly higher than in matching serum. Total IgG, IgA, and IgM in the skin were not higher than expected, however. Attempts to demonstrate increases in intracutaneous levels of specific anti-Mycobacterium leprae antibodies were unsuccessful. This is the first report of the demonstration of IC in suction blister fluid. The results indicate that large quantities of IC may be present in cutaneous leprosy lesions and are consistent with the hypothesis that they are formed in situ when circulating antibody combines with antigen in the skin. The nature of the antigen in these IC remains undefined.

Antibodies↗
PubMed1956

Systemic manifestations of erythema nodosum.

The systemic manifestations accompanying erythema nodosum can be differentiated from those associated with the precipitating infectious process and from coincident disease processes. Erythema nodosum itself is characterized by (a) skin lesions at pressure sites, (b) malaise, fever and occasionally chills, (c) arthritis (70 per cent) and (d) over-reactivity of tissue. Tissue hypersensitivity is most pronounced at sites of trauma, at sites of specific skin testing, and in the lymphoid system draining infections in the pharynx and lung. Common infections of the respiratory tract most often antedate attacks of erythema nodosum. In New England, a beta-hemolytic streptococcus infection is a common causative factor, and tuberculosis is an unusual causative factor. In endemic areas, coccidioidomycosis is a common cause of erythema nodosum. The most important coincidental disease process is rheumatic heart disease. Rarely is it a sequel of erythema nodosum. Other "collagen diseases" may coexist with erythema nodosum. Erythema nodosum is its own most common complication. Follow-up studies indicate that over half of the patients have a subsequent attack, and a certain number have recurrent episodes for months to years. The management of erythema nodosum is expectant. In each case the cause should be found and treated. Steroid treatment is rarely justified, and should be used only after tuberculosis and other treatable entities have been ruled out.

Arthritis↗
PubMed1993

[Erythema nodosum in sarcoidosis patients].

Erythema nodosum was registered in 45 from 502 sarcoidosis patients (9%). Erythema often arose in initial sarcoidosis, but was also recorded in the disease recurrences. Sarcoidosis of the skin and subcutaneous fat occurred in 16 and 4 patients, respectively, this incidence being half of that for erythema nodosum. Sarcoidosis of the above sites is the second in occurrence among extrapulmonary lesions following those of peripheral lymph nodes. Positive effects in the treatment of erythema nodosum were reached after administration of corticosteroids, noncorticosteroid anti-inflammatory drugs, physiotherapy, local therapy.

Adult↗
PubMed1994

Recurrent erythema nodosum in an aviator.

Erythema nodosum is an uncommon skin eruption frequently associated with underlying infections, systemic diseases, or drug toxicity. We report the case of a 27-year-old aviator with three occurrences of erythema nodosum attributed to streptococcal pharyngitis. We review the causes of erythema nodosum to emphasize the importance of a thorough investigation to rule out serious underlying disease prior to returning an aviator to flight status.

Adult↗
PubMed1977

[Histopathology of erythema nodosum].

The histopathology of erythema nodosum is discussed with reference to the literature and of 19 cases of our clinic. There is a significant vascular involvement especially of the subcutaneous tissue. The veins and arteries are equally affected. The histological picture consists not only of an acute inflammatory process in the subcutaneous tissue, but also of inflammatory cells which area see to a lesser extent in the dermis. In many cases the typical small granulomatous foci of MIESCHER which are considered to be pathognomonic for erythema nodosum do not develop. In the cases which we examined we were not always able to tell from the histological picture how long the erythema nodosum had been present. Multinucleated giant cells which are often found in the septal connective tissue are seen even in relatively acute cases.

Acute Disease↗
PubMed1979

Investigation of coagulation abnormalities in patients with erythema nodosum leprosum.

Twenty erythema nodosum leprosum (ENL) patients were examined. Coagulation studies were carried out in 13 of them during their active stage and 7 in the latent stage. From these 13 patients, 6 were re-examined when the disease became latent. From these observations a conclusion can be drawn that there are coagulation abnormalities in the majority of ENL patients in the active stage and these abnormalities will return to normal values when the disease becomes latent.

Blood Coagulation Disorders↗
PubMed1978

Erythema nodosum. A review.

Erythema nodosum is not an uncommon dermatologic entity. Sarcoidosis and streptococcal infection have become the two most common causes, while tuberculosis was the predominant etiology prior to the use of isoniazid. Histoplasmosis and coccidioidomycosis are two important geographic considerations. Laboratory tests should include a PPD test, chest x-ray, throat culture for beta-streptococcus, and ASO titer determination as a minimum. Symptomatic treatment remains unsatisfactory in many cases, although recent success has been reported with oral potassium iodide.

Bacterial Infections↗
PubMed1982

Suppression of erythema nodosum by indomethacin.

Erythema nodosum (EN) can be a debilitating illness. Many treatment modalities have been suggested but none is universally effective. We describe three patients with severe EN secondary to streptococcal pharyngitis who were unresponsive to large doses of aspirin. Following the administration of indomethacin in doses of 100 to 150 mg per day, all three showed a dramatic response, with prompt resolution both of systemic symptoms and of local signs of inflammation. The lesions of EN involve the lower cutis, with inflammation of septae and fat lobules. It is likely, therefore, that the local liberation of fatty acids leads to increased prostaglandin synthesis which, in turn, is responsible for the intense inflammation. The impressive suppression of EN by indomethacin could be related to the inhibition of prostaglandin synthetase in the subcutaneous fatty tissues.

Adult↗
PubMed1984

[Erythema nodosum and Crohn's disease].

Erythema nodosum was found on 11 out of 106 patients with Crohn's disease (10.4%), being the most common skin complication after the perianal ones. Women were affected more often than men (2.7:1) and most of the patients were above 15 and below 40 years of age. Patients with ileocolic lesions were more often affected than those with lesions confined to the small bowel. No cases of erythema nodosum were found in association with granulomatous colitis, as opposed to other authors experience. The eruption was usually related to the periods of active inflammatory bowel disease but not to the administration of salazopyrine. The morphology and evolution of the lesions was typical of erythema nodosum and joint involvement was almost constant. The differential diagnosis with other nodular eruptions that can occur in association with Crohn's disease are discussed and hypothetical common etiopathogenic factors to both Crohn's disease and erythema nodosum are briefly considered. The relevant literature is reviewed and commented upon.

Adolescent↗
PubMed1985

Erythema nodosum following typhoid vaccination.

Erythema nodosum has recently been recognised in association with salmonella infection (1). We report a case of classical erythema nodosum which developed following a typhoid vaccination.

Erythema Nodosum↗
PubMed1978

Yersinia enterocolitica as a cause of erythema nodosum.

54 cases of erythema nodosum, seen in the Department of Dermatology at the St. Raphael University Hospital, Louvain, were reviewed for their possible aetiology. A search for Yersinia enterocolitica (Y.e.) agglutinins was performed in 21 patients of whom 8 had significant serum antibody titres. These cases are presented and discussed. Gastro-intestinal symptoms, preceding by 2 weeks the erythema nodosum, are strongly suggestive for an aetiologic link with Y.e. Our observations confirm and extend to this part of Europe, the experience of other, mainly Scandinavian, authors.

Adolescent↗
PubMed1997

Elevated Th1 cytokine mRNA in skin biopsies and peripheral circulation in patients with erythema nodosum.

It is generally believed that erythema nodosum is the result of an immunologic attack centered within the subcutaneous fat. This belief, however, is based on indirect evidence. The aim of this study was to analyze whether erythema nodosum could represent an example of a polarized Th1 or Th2 immune response. We have studied herein, by semiquantitative coupled reverse transcription-polymerase chain reaction the Th1 (IL-2, IFN-gamma) and Th2 (IL-4, IL-10) cytokine gene expression in skin biopsies and peripheral blood from eleven patients with erythema nodosum. As controls, we studied skin and peripheral blood from nine healthy subjects. We found expression of Th1 cytokines in most erythema nodosum skin lesions as well as in their peripheral blood. Both Th1 and Th2 cytokine gene expressions were scarcely or not detected in the skin and peripheral blood of control subjects. These results directly demonstrate that a polarized Th1 immune response occurs in the skin lesions of erythema nodosum patients regardless of the wide variety of provoking agents.

Adolescent↗