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Usually acute bouts of erythema nodosum are associated with a fever of 38-39 C°, fatigue, malaise, arthralgia, headache, abdominal pain, vomiting, cough, or diarrhea.

Episcleral lesions and phlyctenular conjunctivitis may also accompany the cutaneous lesions.

The nodules, which range from 1 to 5 cm or more in diameter, are usually bilaterally distributed (Figures 1-3).

Nodules may become confluent resulting in erythematous plaques (Figure 4).

Prevalence of erythema nodosum in a semirural area of England over a 2-year period gave a figure of 2. population per year.[7] Prevalence varies also according to the type of the patients attended to in a clinic: the average hospital incidence was about 0.5 percnet of new cases seen in Departments of Dermatology in England[8] and about 0.38 percent of all patients seen in a Department of Internal Medicine in Spain.[9] In a recent study, the average annual incidence rate of biopsy proven erythema nodosum in a hospital of the northwestern Spain for the population 14 years and older was 52 cases per million of persons, although certainly this rate underestimated the authentic incidence of the disease because only included cases confirmed by biopsy.[10] Most cases of erythema nodosum occur within the first half of the year, probably due to the more frequent incidence of streptococcal infections in this period of the year, and there is no difference in distribution between urban and rural areas.[8, 10] Familial cases are usually due to an infectious etiology. 4.- A: Nodules may become confluent resulting in erythematous plaques.

The lesions show spontaneous regression, without ulceration, scarring, or atrophy, and recurrent episodes are uncommon. The composition of the inflammatory infiltrate in the septa varies with age of the lesion. In early lesions edema, hemorrhage, and neutrophils are responsible for the septal thickening, whereas fibrosis, periseptal granulation tissue, lymphocytes, and multinucleated giant cells are the main findings in late stage lesions of erythema nodosum. Erythema nodosum in an epidemic of histoplasmosis in Indianapolis. Erythema nodosum is a cutaneous reactive process that may be triggered by a wide variety of possible stimuli. Infectious diseases, sarcoidosis, rheumatologic diseases, inflammatory bowel diseases, medication reactions, autoinmune disorders, pregnancy, and malignancies the most common associated conditions.

The lesions show spontaneous regression, without ulceration, scarring, or atrophy, and recurrent episodes are uncommon.

The composition of the inflammatory infiltrate in the septa varies with age of the lesion.

In early lesions edema, hemorrhage, and neutrophils are responsible for the septal thickening, whereas fibrosis, periseptal granulation tissue, lymphocytes, and multinucleated giant cells are the main findings in late stage lesions of erythema nodosum. Erythema nodosum in an epidemic of histoplasmosis in Indianapolis.

Erythema nodosum is a cutaneous reactive process that may be triggered by a wide variety of possible stimuli.

Infectious diseases, sarcoidosis, rheumatologic diseases, inflammatory bowel diseases, medication reactions, autoinmune disorders, pregnancy, and malignancies the most common associated conditions.

Erythema nodosum was originally described in 1798 by the English dermatologist, Willan, in his classic monograph on erythemas, and this author emphasized the higher frequency of the process in women.[1]The disorder was further delineated by Wilson in 1842, who considered erythema nodosum to be a part of erythema multiforme because he had observed urticaria, figurate erythema, purpura, and the nodose lesions to overlap.[2] Later, Hebra, in 1860, expanded the clinical characteristics of the process and described the color changes in the evolution of the lesions, proposing the term dermatitis contusiformis to name the disorder.[3] This process can occur at any age, but most cases appear between the second and fourth decades of the life, with the peak of incidence being between 20 and 30 years of age, due to the high incidence of sarcoidosis at this age.[4] Several studies have demonstrated that erythema nodosum occurs three to six times more frequently in women than in men, however, the sex incidence before puberty is approximately equal.[5, 6] In general, erythema nodosum is seen in younger patients than erythema induratum of Bazin.