Mitchell Hanson, McKenzie E. Maloney, Louis Kuchnir
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引用次数: 0
摘要
背景:结节性红斑(EN结节性红斑(EN)是一种皮下脂肪炎症。病因包括自身免疫性疾病、药物、感染、妊娠、恶性肿瘤和特发性病因。病例:一名 37 岁的女性,曾患复发性蜂窝组织炎和 II 型糖尿病,在赫尔利化脓性扁桃体炎(HS)III 期复发期间,上肢肿块恶化达四个月之久。检查发现上肢弥漫性水肿上有多个红斑脓疱和温暖的凹陷性结节。三甲双胍/磺胺甲噁唑、头孢氨苄、克林霉素和左氧氟沙星均无效。血常规化验、血沉和ANA均无异常。EN 被确诊。医生给他开了三甲双氨/磺胺甲恶唑、饱和碘化钾溶液(SSKI)和布洛芬。随访三周后,除一处皮损外,EN已完全消退。讨论文献综述显示,有一例EN表现与HS有关,但因贝切氏综合征而并发。我们认为 HS 是导致 EN 的潜在原因,而 SSKI 是治疗 EN 和 HS 的有效方法。
Exploring the connection between hidradenitis suppurativa and erythema nodosum: a case report
Background: Erythema nodosum (EN) is inflammation of subcutaneous fat. Etiologies include autoimmune diseases, drugs, infections, pregnancy, malignancy, and idiopathic origins. Case: A 37- year-old female with a history of recurrent cellulitis and type II diabetes presented with worsening swollen lumps on upper extremities for four months during a Hurley Stage III hidradenitis suppurativa (HS) flare. Exam revealed multiple erythematous pustules and warm indurated nodules over diffuse edema on the upper extremities. Lesions were refractory to trimethoprim/sulfamethoxazole, cefalexin, clindamycin and levofloxacin. Routine blood labs, ESR, and ANA were unremarkable. EN was diagnosed. Trimethoprim/sulfamethoxazole, saturated solution potassium iodide (SSKI) and ibuprofen were prescribed. At three week follow-up, EN had completely resolved except for one lesion. Discussion: Literature review revealed one case of EN manifestation in association with HS but was complicated by Beçhet’s syndrome. We propose HS as an underlying cause of EN and SSKI an effective treatment for EN and HS.