1/7. Case report: bilateral ankle pain in an aerobic dancer.A 32-yr-old female presented to Sports Clinic with bilateral ankle pain and swelling following the initiation of an aerobic dance program 3 months earlier. Physical exam revealed bilateral ankle edema and the recent appearance of discrete tender nodules on her anterior tibias, consistent with erythema nodosum (EN). As part of her evaluation, chest radiographs were performed and demonstrated bilateral hilar adenopathy. This case discusses the evaluation of the patient with joint involvement, EN, and hilar adenopathy. The increased accessibility of sports medicine clinics makes it incumbent on the physician to be familiar with a wide range of differential diagnoses.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/7. Successful treatment of chronic erythema nodosum with vitamin B12.A 38-year-old woman presented with painful lesions on both shins that first appeared a few days earlier. physical examination revealed multiple red tender nodules on both legs. The patient had been treated with nonsteroidal anti-inflammatory drugs for having a few months without any improvement. The patient was referred to a dermatologist and a rheumatologist, who confirmed our diagnosis of chronic erythema nodosum (EN). She returned to the clinic 3 months later complaining of having numbness in the soles of her feet for a few weeks. Her serum vitamin B12 level was 118 pg/mL (normal range 135 to 911). After 4 weeks of twice weekly injections of vitamin B12 at a dose of 1000 mcg, there was a clear alleviation of the numbness, and the EN completely resolved without evidence of recurrence on follow-up. Because it seems that vitamin B12 caused resolution of EN in this case, we recommend that physicians consider testing for vitamin B12 deficiency in patients with EN.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/7. erythema nodosum following a jellyfish sting.At least 100 of the approximately 9,000 species of coelenterates are dangerous to humans. The most common syndrome following an envenomation is an immediate intense dermatitis, with characteristic skin discoloration, local pain, and systemic symptoms. In this case report, we describe a case of erythema nodosum with articular manifestations following envenomation with an unknown jellyfish. Serological testing of the victim revealed marked elevation of immunoglobulins G and M directed against Physalia physalis, the Portuguese man-of-war. The patient's condition did not respond to conventional topical therapy for coelenterate envenomation, but was successfully managed with systemic corticosteroid therapy. This case demonstrates that the emergency physician should consider a delayed reaction to a marine envenomation in any victim who presents with an acute dermatological disease following immersion in marine coastal waters.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
4/7. Painful red leg nodules and syphilis: a consideration in patients with erythema nodosum-like illness.An adolescent girl presented with the classical physical findings of painful red nodules on the legs; the lesions were suggestive of erythema nodosum. The usual underlying causes were explored and found to be absent. Because she was sexually active, the patient was also routinely screened for sexually transmitted diseases. A rapid plasma reagin test was performed and found to be strongly positive. The confirmatory fluorescent treponemal antibody test was also positive. A diagnosis of syphilis was made, and she was treated with benzathine penicillin g (2.4 X 10(6) units). This report is a reminder that when a patient is suspected of having erythema nodosum, the physician should check for syphilis as well as for tuberculosis, sarcoidosis, reaction to a drug, and streptococcal disease. panniculitis can be an important clinical sign of secondary syphilis that should never be overlooked.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
5/7. Behcet's disease.Behcet's disease is characterized by three primary components: iridocyclitis (historically with hypopyon), aphthous lesions in the mouth, and ulceration of the genitalia. erythema nodosum, arthropathy and thrombophlebitis often accompany these manifestations, but the ocular symptoms may be the most important and serious manifestations of the disease. central nervous system involvement, most often due to necrotizing vasculitis, may be the most protean manifestation of the disease, leading to death. The frequency of ocular manifestations is 70-85% in patients with the disease; the underlying disease mechanism in all organ systems is an occlusive vasculitis. Although the most common ocular symptom is that of anterior uveitis, often with hypopyon as a very late sign, the presence of necrotizing retinal vascular lesions is well known and often obscured by the severity of the anterior reaction. Definitions, incidence, clinical characteristics, differential diagnosis, and management of Behcet's ocular disease are discussed, as are the interrelationships of the different organ manifestations. The ophthalmologist should be familiar with the full spectrum of disease presentation since he or she may be the first physician to encounter the Behcet's patient.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
6/7. Lofgren's syndrome.Lofgren's syndrome consists of a triad of erythema nodosum, bilateral hilar adenopathy, and arthritis and heralds the acute onset of sarcoidosis. A single symptom may be misdiagnosed and mistreated by an unsuspecting physician. We present a case of Lofgren's syndrome that was initially believed to be cellulitis. We briefly review the course and treatment of Lofgren's syndrome.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
7/7. Sweet's syndrome associated with erythema nodosum.The association between Sweet's syndrome and erythema nodosum in the same patient is rare. However, it is important that family physicians recognise how to differentiate these conditions clinically and histopathologically. A case is described with a combination of Sweet's syndrome and erythema nodosum, and appropriate treatment is discussed.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |