Cases reported "Erythema Nodosum"

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1/13. Sweet's syndrome evolved from recurrent erythema nodosum in a patient with myelodysplastic syndrome.

    A 63-year-old man had painful nodules on his lower legs. Microscopic examination showed septal and lobular panniculitis composed of lympho-histiocytic infiltrates. Based on the clinical and histopathological findings, the diagnosis of erythema nodosum (EN) was made. Nonsteroidal anti-inflammatory drugs were temporarily effective, but the eruptions had repeated to the present, and 16 months later, myelodysplastic syndrome (MDS) was diagnosed. Then, 6 months later, he developed a high fever and edematous fresh red-colored nodules on his neck, arm and upper trunk. Histopathologically, a diffuse, dense, dermal infiltrate of neutrophils was seen, and Sweet's syndrome (SS) was diagnosed. SS is known to develop in patients with MDS, and EN is one of the dermatoses that occur in conjunction with hematoproliferative disorders. Furthermore, SS evolving from recurrent EN and the simultaneous occurrence of SS and EN have been reported in some patients. In our case, we suggest that some mediators such as cytokines associated with MDS might have first induced EN, and then, as the MDS developed, they were replaced by others that caused SS.
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2/13. cytodiagnosis of erythema nodosum leprosum. A case report.

    BACKGROUND: The application of cytology in leprosy has been restricted to the evaluation of morphologic and bacterial indices by slit skin smears to facilitate diagnosis of cases according to the Ridley-Jopling scale. Isolated reports have now documented the use of fine needle aspiration cytology (FNAC) in the diagnosis of leprosy. CASE: A 45-year-old male presented with the abrupt onset of multiple nodular eruptions all over the body. The clinical diagnosis was Sweet's syndrome. FNAC showed numerous neutrophils in a background of foamy macrophages. Special stains revealed the presence of a large number of fragmented acid-fast bacilli in the smears. A diagnosis of erythema nodosum leprosum (ENL) was made on FNAC. CONCLUSION: The presence of neutrophils in a characteristic milieu of foamy macrophages is seen in lesions of ENL. Such a picture should prompt the cytologist to use a modified Ziehl-Neelsen stain to demonstrate acid-fast bacilli, as ENL can present as an acute episode in patients without a previous diagnosis of leprosy.
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3/13. erythema nodosum and granulomatous lesions preceding acute myelomonocytic leukemia.

    A 65-year-old female with a one-month history of painful eruptions on her lower extremities was admitted to our hospital. Histological examination revealed erythema nodosum (EN), and the patient was treated with oral prednisolone (PSL; 20 mg daily). The eruptions subsided in two weeks. One month later, painful reddish eruptions recurred on her upper limbs and abdomen in addition to her lower extremities. A skin biopsy from an abdominal erythematous plaque revealed a non-caseating granuloma without microorganisms or foreign-body materials. These eruptions also disappeared with treatment with oral PSL (20 mg daily). No underlying disease, including sarcoidosis, diabetes mellitus, or rheumatoid arthritis, was found. However, five months later, the patient developed conspicuous leukocytosis. She was diagnosed with acute myelomonocytic leukemia (M4) and treated with chemotherapy. After complete remission had been achieved, the EN reappeared, in association with an increase in blastic cells in the bone marrow. serum levels of tumor necrosis factor-alpha and interleukin-1 beta, which are thought to be essential for granuloma formation and induction of EN, were markedly elevated. physicians must remember that recurrent EN and granulomatous lesions can be a prodromal sign of leukemia.
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4/13. Cutaneous manifestations of systemic disease.

    BACKGROUND: While most patients who present with a rash have no associated systemic illness, many systemic illnesses have skin manifestations at some stage. OBJECTIVE: This article uses case vignettes to illustrate a problem oriented approach to five commonly presented skin conditions that have common and varied systemic associations. A logical sequence of management for each case is provided. DISCUSSION: Often the skin manifestations of systemic disease are vague and nonspecific such as the toxic erythema that might follow a viral infection or a drug eruption. Sometimes it is the systemic manifestations that are vague and nonspecific, while the skin manifestations are highly specific and define the illness. There is currently no useful classification for cutaneous manifestations of systemic disease.
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5/13. The differential diagnosis of erythema nodosum.

    erythema nodosum is an uncommonly seen skin eruption which may be a marker of underlying systemic or infectious disease. It may also occur as a reaction to a variety of medications. The diagnosis of erythema nodosum should prompt a thorough investigation of possible causes or associated conditions which may be treatable. This paper presents a case of erythema nodosum and reviews the differential diagnosis of its causes and of similar appearing skin lesions.
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6/13. erythema nodosum associated with acute cytomegalovirus mononucleosis in an adult.

    Acute cytomegalovirus mononucleosis has been associated with maculopapular rashes, petechiae, purpura, urticaria, ulcerative lesions, and vesicular eruptions. Although erythema nodosum has been reported in association with a number of infectious and noninfectious diseases, to our knowledge it has not been associated with cytomegalovirus infections. We report the first case of an adult patient with acute cytomegalovirus mononucleosis who presented with erythema nodosum.
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7/13. Type 1 (reversal) lepra reaction in borderline leprosy with unusual clinical presentation--a case report.

    A male 26 years old patient with BB type of leprosy was encountered with a typical clinical presentations of up-grading (reversal) Type 1 Lepra Reaction. These included sudden appearance of tender, erythematous nodular eruptions mimicking ENL, severe constitutional symptoms like high grade fever, malaise, vomiting, epistaxis, joint pain and tenosynovitis simulating Type 2 Lepra Reaction. To the best of our knowledge, this may be the first such case in our hand.
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8/13. thalidomide--effect on T cell subsets as a possible mechanism of action.

    thalidomide is the drug of choice in the erythema nodosum leprosum (ENL) type of lepra reaction. Lately it has been used successfully in other diseases, such as discoid lupus erythematosus, actinic prurigo, Behcet's disease, etc. However, its mechanism of action remains unknown. In patients for whom thalidomide provided relief in their disorder, the proportions of T lymphocytes and their subsets in peripheral blood were assessed by means of monoclonal antibodies. Three lepromatous leprosy patients with ENL had their T helper populations significantly increased after thalidomide therapy. A 14-year-old girl with Behcet's syndrome showed a consistent decrease in Ia cells throughout her three-month course of thalidomide therapy. The same findings were observed in two patients with the actinic prurigo type of polymorphous light eruption. From these results, we conclude that thalidomide may act as an immunomodulating agent on T cell subsets.
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9/13. erythema nodosum and erythema multiforme associated with milker's nodules.

    An epidemic of 44 cases of milker's nodules was recorded in the Tampere Central Hospital catchment area in finland during the autumn of 1974. exanthema or erythema multiforme-like secondary eruptions were seen in 10 cases. One female patient is reported in detail because of the simultaneous occurrence of erythema nodosum and erythema multiforme. The virological diagnosis was confirmed by electron microscopy.
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10/13. Annular vasculitis of the head and neck in a patient with sarcoidosis.

    A patient with bilateral hilar lymphadenopathy due to sarcoidosis presented with erythema nodosum on the shins and upper arms and an unusual annular eruption resembling erythema annulare centrifugum on the head and neck. biopsy of the latter showed a leucocytoclastic angiitis.
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