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Erythema nodosum in children: a prospective study
T Kakourou1, P Drosatou, F Psychou
1First Department of Pediatrics, and the Department of Pathology, Athens University, Greece.
Journal of the American Academy of Dermatology
|January 10, 2001
Summary
Erythema nodosum (EN) in children is often caused by infections, particularly beta-hemolytic streptococcus. While generally benign, Mycobacterium tuberculosis should be considered, and recurrences are rare.
Area of Science:
- Pediatric Dermatology
- Infectious Diseases
- Rheumatology
Background:
- Limited studies exist on pediatric erythema nodosum (EN), with most being retrospective.
- Understanding the epidemiology and clinical course of EN in children is crucial.
Purpose of the Study:
- To evaluate the epidemiology, etiology, clinical features, course, and prognosis of erythema nodosum in a pediatric cohort.
- To identify common causes and outcomes of EN in children.
Main Methods:
- A prospective study of 35 children diagnosed with erythema nodosum.
- Exclusion of four children with biopsy-proven leukocytoclastic vasculitis or eosinophilic cellulitis.
- Laboratory investigations to determine the etiology of EN.
Main Results:
- Infectious agents were identified as the cause in 77% of cases, with beta-hemolytic streptococcus being the most frequent (n=17).
- Mycobacterium tuberculosis, Crohn's disease, and Hodgkin's disease were less common etiologies.
- The mean duration of the rash was 11.5 days, and recurrences were exceptional (2 children).
Conclusions:
- Beta-hemolytic streptococcus is the predominant cause of EN in children in Greece.
- Mycobacterium tuberculosis remains a significant consideration for pediatric EN.
- Erythema nodosum in children typically follows a benign course with rare relapses.