CHRONIC ERYTHEMA NODOSUM AS A SIGN OF TUBERCULOSIS INFECTION

Authors

  • dr. Tara Sefanya Kairupan, M.Kes, Ph.D Department of Dermatology and Venereology, Sam Ratulangi University
  • dr. Aryani Adji, Sp.KK(K), FINSDV, FAADV Department of Dermatology and Venereology, Faculty of Medicine, Sam Ratulangi University, Manado
  • dr. Marlyn Grace Kapantow, Sp.KK(K), FINSDV, FAADV Department of Dermatology and Venereology, Faculty of Medicine, Sam Ratulangi University, Manado

DOI:

https://doi.org/10.66344/jpad.32.3.2022.1965

Abstract

Abstract Introduction: Erythema nodosum (EN) is a subcutaneous fat tissue inflammation (panicullitis) characterized by diffuse erythematous nodules symmetrically distributed in the anterior part of the lower extremities. EN is considered as a reactive process which can be triggered by a wide variety of factors including mycobacterium (M.) tuberculosis infection. Case: A 21-year-old woman, presented in our department with a 9-month-history of painful erythematous nodules on both legs accompanied by ankle swelling and joint pain. Previous treatments with amoxicillin-clavulanic acid, steroid, and nonsteroidal anti-inflammatory drug (NSAID) did not yield satisfactory results. On examination, we found multiple tender erythematous nodules symmetrically distributed on both legs. On laboratory examination, C-reactive protein and erythrocyte sedimentation rate were increased, interferon-gamma release assay (IGRA) test was found positive for M. tuberculosis infection. The patient was treated with standard anti-tuberculosis regimen and hexagonal water without additional steroids or other immunosupressive drugs. Clinical resolution was gradually achieved and by the third month of therapy only minimal post-inflammatory hyperpigmentation lesions remained. Discussion: EN is a self-limiting disease but in certain cases can be chronic and refractory. Identification and elimination of underlying causes of EN are essential to achieve satisfying results. Conclusion: We reported a case of EN with positive IGRA result for M. tuberculosis infection which was successfully treated with anti-tuberculosis regimen. Keywords: erythema nodosum, mycobacterium tuberculosis, interferon gamma release assay, anti-tuberculosis drugs

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Published

2022-08-27

How to Cite

1.
Kairupan TS, Adji A, Kapantow MG. CHRONIC ERYTHEMA NODOSUM AS A SIGN OF TUBERCULOSIS INFECTION. J Pak Assoc Dermatol [Internet]. 2022Aug.27 [cited 2026Apr.22];32(3):642-6. Available from: https://www.jpad.com.pk/index.php/jpad/article/view/1965

Issue

Vol. 32 No. 3 (2022): July - September

Section

Case Reports

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