Eritema nodoso: Causas más prevalentes en pacientes que se hospitalizan para estudio, y recomendaciones para el diagnóstico

Background: Erythema Nodosum (EN) is an acute nodular erythematous cutaneous eruption. It is presumed to be a hypersensitivity reaction and it may be idiopathic, or occur in association with diverse diseases and medications. Aim: To identify the main etiologies of EN among patients admitted to a med...

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Autores principales:	Varas,Pablo, Antúnez-Lay,Andrea, Bernucci,José Miguel, Cossio,Laura, González,Sergio, Eymin,Gonzalo
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2016
Materias:	Erythema nodosum Inflammatory bowel diseases Sarcoidosis Streptococcal Infections Tuberculosis
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016000200003
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spelling	oai:scielo:S0034-988720160002000032016-04-13Eritema nodoso: Causas más prevalentes en pacientes que se hospitalizan para estudio, y recomendaciones para el diagnósticoVaras,PabloAntúnez-Lay,AndreaBernucci,José MiguelCossio,LauraGonzález,SergioEymin,Gonzalo Erythema nodosum Inflammatory bowel diseases Sarcoidosis Streptococcal Infections Tuberculosis Background: Erythema Nodosum (EN) is an acute nodular erythematous cutaneous eruption. It is presumed to be a hypersensitivity reaction and it may be idiopathic, or occur in association with diverse diseases and medications. Aim: To identify the main etiologies of EN among patients admitted to a medicine service of a clinical hospital. Material and Methods: Analysis of medical records of patients discharged with the diagnosis of EN during a ten years period. Patients were considered to have secondary EN when an underlying condition was found, and to have idiopathic EN when no such condition was found. Results: One hundred twenty nine patients were identified, but 91, aged 38 ± 14 years (86% females) had available clinical information. The etiology was idiopathic in 32% and secondary in 68% of patients. The leading etiologies were post-Streptococcal in 32%, followed by sarcoidosis in 11%, primary tuberculosis in 7%, Mycoplasma infection in 3%, Bartonella infection in 3%, Behçet’s syndrome in 2%, inflammatory bowel disease in 2%, drugs in 1% and other etiologies in 8%. Secondary cases of EN had higher levels of C Reactive Protein and leucocytes than idiopathic cases. Conclusions: The distribution of causes in our study population were similar to those reported in the literature (With smaller proportion of idiopathic), as was the man/woman (1/6) ratio, and the preponderance of cases in winter and spring. Infectious diseases were the leading causes of EN in this group of patients, and a reasonable initial approach in the hospital should include a diligent medical history and physical examination, complete blood count, ESR, titles ASO, PPD tuberculin skin test, chest X-ray or CT scan and, where deemed appropriate, specific autoimmune and infectious serology.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.144 n.2 20162016-02-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016000200003es10.4067/S0034-98872016000200003
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Erythema nodosum Inflammatory bowel diseases Sarcoidosis Streptococcal Infections Tuberculosis
spellingShingle	Erythema nodosum Inflammatory bowel diseases Sarcoidosis Streptococcal Infections Tuberculosis Varas,Pablo Antúnez-Lay,Andrea Bernucci,José Miguel Cossio,Laura González,Sergio Eymin,Gonzalo Eritema nodoso: Causas más prevalentes en pacientes que se hospitalizan para estudio, y recomendaciones para el diagnóstico
description	Background: Erythema Nodosum (EN) is an acute nodular erythematous cutaneous eruption. It is presumed to be a hypersensitivity reaction and it may be idiopathic, or occur in association with diverse diseases and medications. Aim: To identify the main etiologies of EN among patients admitted to a medicine service of a clinical hospital. Material and Methods: Analysis of medical records of patients discharged with the diagnosis of EN during a ten years period. Patients were considered to have secondary EN when an underlying condition was found, and to have idiopathic EN when no such condition was found. Results: One hundred twenty nine patients were identified, but 91, aged 38 ± 14 years (86% females) had available clinical information. The etiology was idiopathic in 32% and secondary in 68% of patients. The leading etiologies were post-Streptococcal in 32%, followed by sarcoidosis in 11%, primary tuberculosis in 7%, Mycoplasma infection in 3%, Bartonella infection in 3%, Behçet’s syndrome in 2%, inflammatory bowel disease in 2%, drugs in 1% and other etiologies in 8%. Secondary cases of EN had higher levels of C Reactive Protein and leucocytes than idiopathic cases. Conclusions: The distribution of causes in our study population were similar to those reported in the literature (With smaller proportion of idiopathic), as was the man/woman (1/6) ratio, and the preponderance of cases in winter and spring. Infectious diseases were the leading causes of EN in this group of patients, and a reasonable initial approach in the hospital should include a diligent medical history and physical examination, complete blood count, ESR, titles ASO, PPD tuberculin skin test, chest X-ray or CT scan and, where deemed appropriate, specific autoimmune and infectious serology.
author	Varas,Pablo Antúnez-Lay,Andrea Bernucci,José Miguel Cossio,Laura González,Sergio Eymin,Gonzalo
author_facet	Varas,Pablo Antúnez-Lay,Andrea Bernucci,José Miguel Cossio,Laura González,Sergio Eymin,Gonzalo
author_sort	Varas,Pablo
title	Eritema nodoso: Causas más prevalentes en pacientes que se hospitalizan para estudio, y recomendaciones para el diagnóstico
title_short	Eritema nodoso: Causas más prevalentes en pacientes que se hospitalizan para estudio, y recomendaciones para el diagnóstico
title_full	Eritema nodoso: Causas más prevalentes en pacientes que se hospitalizan para estudio, y recomendaciones para el diagnóstico
title_fullStr	Eritema nodoso: Causas más prevalentes en pacientes que se hospitalizan para estudio, y recomendaciones para el diagnóstico
title_full_unstemmed	Eritema nodoso: Causas más prevalentes en pacientes que se hospitalizan para estudio, y recomendaciones para el diagnóstico
title_sort	eritema nodoso: causas más prevalentes en pacientes que se hospitalizan para estudio, y recomendaciones para el diagnóstico
publisher	Sociedad Médica de Santiago
publishDate	2016
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016000200003
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Eritema nodoso: Causas más prevalentes en pacientes que se hospitalizan para estudio, y recomendaciones para el diagnóstico

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