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    1 OF 87

    Intestinal granulomatous disease: what is the first call.
    BMJ Case Rep 2018 Apr 19;2018. Epub 2018 Apr 19.
    Infectious Diseases Unit, Kaplan Medical Center, Rehovot, Israel.
    A 15-year-old girl presented with erythema nodosum and mild abdominal complaints. Her intestinal granulomatous disease was erroneously diagnosed as Crohn's disease despite the fact that the possibility of tuberculosis was considered. The final diagnosis of tuberculosis was made only when an anti-tumour necrosis factor therapy resulted in further deterioration. Read More

    Can anti-PGL-1 and anti-NDO-LID-1 antibody titers be used to predict the risk of reactions in leprosy patients?
    Diagn Microbiol Infect Dis 2018 Mar 16. Epub 2018 Mar 16.
    Instituto Lauro de Souza Lima, Bauru, SP, Brazil. Electronic address:
    Leprosy patients may present reactional episodes classified as type I or reversal reaction and type II or erythema nodosum leprosum. Early diagnosis of these reactions is hampered by lack of diagnostic tests. This study aimed at evaluating anti-Mycobacterium leprae antibody levels in reactional and nonreactional leprosy patients at the time of diagnosis. Read More

    Extraintestinal Manifestations in Vedolizumab and Anti-TNF-Treated Patients With Inflammatory Bowel Disease.
    Inflamm Bowel Dis 2018 Apr 13. Epub 2018 Apr 13.
    AbbVie Inc., North Chicago, Illinois.
    Background: Extra-intestinal manifestations (EIMs) can impact morbidity in patients with inflammatory bowel diseases (IBD; Crohn's disease [CD] and ulcerative colitis [UC]). This study compared incidence rates of EIMs in patients with moderate to severe IBD receiving gut-selective vedolizumab (VDZ) vs those receiving systemic anti-tumor necrosis factor (anti-TNF) therapies.

    Methods: Adult IBD patients receiving VDZ or anti-TNFs were identified from the MarketScan claims database from September 28, 2012, through September 30, 2016. Read More

    Successful mesenchymal stem cell treatment of leg ulcers complicated by Behcet disease: A case report and literature review.
    Medicine (Baltimore) 2018 Apr;97(16):e0515
    Department of Rheumatology, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.
    Rationale: Behçet disease (BD) is a recurrent vasculitis characterized by oral and genital mucous membrane ulcers, uveitis, and skin lesions but only rarely leg ulcers. To our knowledge, no efficacious therapy has been described for BD patients with complicating, destructive leg ulcers.

    Patient Concerns: Here, We report the case of a 55-year-old woman with generalized erythema nodosum-like, papulopustular lesions, recurrent oral and genital ulcers accompanied with recurrent leg ulcers and trouble walking. Read More

    Exploring the combination of SSKI and topical heparin in a case of erythema nodosum migrans.
    Dermatol Ther 2018 Apr 11:e12610. Epub 2018 Apr 11.
    Department of Dermatology, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, 110001, India.
    Erythema nodosum migrans (subacute nodular migratory panniculitis) is an uncommon type of panniculitis characterized by migrating subcutaneous nodules or plaque on the lower extremity. There are a very few cases of Erythema nodosum migrans reported and thus its appropriate treatment modality is not defined. We describe a case of a 30-year-old male with idiopathic erythema nodosum migrans which was manifest centrifugally spreading, slightly morpheaform erythematous plaque on the lower left leg. Read More

    Poststreptococcal reactive arthritis in Japan.
    J Infect Chemother 2018 Mar 29. Epub 2018 Mar 29.
    Department of Pediatrics, Tokyo Medical University, Tokyo, Japan. Electronic address:
    Reactive arthritis after Group A streptococcal infection (poststreptococcal reactive arthritis: PSRA) that does not meet the Jones criteria for acute rheumatic fever (ARF) has been reported as a new entity for over a decade. In Japan there are few reports of PSRA. We encountered four children with arthritis accompanied with Group A streptococcal infection in our department. Read More

    [Cutaneous sarcoidosis - a great imitator].
    Pol Merkur Lekarski 2018 Mar;44(261):142-146
    Medical University of Gdansk, Poland: Department of Dermatology, Venereology and Allergology.
    Skin manifestation occurs in approximately 25% of patients with sarcoidosis and is often the first symptom of the disease. The availability of skin biopsy material is helpful in establishing the early diagnosis. Cutaneous sarcoidosis is characterized by clinical polymorphism and therefore its diagnosis may cause dilemma. Read More

    Unusual association between erythema nodosum and autoimmune atrophic gastritis.
    BMJ Case Rep 2018 Mar 15;2018. Epub 2018 Mar 15.
    Department of Rheumatology, Hospitais da Universidade de Coimbra, Coimbra, Portugal.
    We report a case of a 46-year-old woman with a history of autoimmune atrophic gastritis and recurrent erythema nodosum (EN). Laboratory results showed iron-deficiency anaemia, positive antiparietal cell antibodies and marginal deficiency of vitamin B12. Although EN was refractory to general measures (rest and non-steroidal anti-inflammatory drugs) and corticosteroid therapy, it was successfully treated with vitamin B12 supplementation. Read More

    Reactive perforating leprosy, erythema multiforme-like reactions, sweet's syndrome-like reactions as atypical clinical manifestations of Type 2 leprosy reaction.
    Int J Mycobacteriol 2018 Jan-Mar;7(1):97-100
    Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran, Dr. Hasan Sadikin General Hospital, Bandung, Indonesia.
    Type 2 leprosy reactions commonly known as erythema nodosum leprosum, but various clinical manifestations of type 2 leprosy reaction were exist. The highlight of this case series was to report various atypical clinical manifestations of type 2 leprosy reaction such as reactive perforating leprosy, erythema multiforme-like reaction, and sweet's syndrome (SS)-like reaction. Read More

    Complement C1q expression in Erythema nodosum leprosum.
    PLoS Negl Trop Dis 2018 Mar 2;12(3):e0006321. Epub 2018 Mar 2.
    London School of Hygiene and Tropical Medicine, Faculty of Infectious Tropical Diseases, London, United Kingdom.
    Complement C1q is a soluble protein capable of initiating components of the classical pathway in host defence system. In earlier qualitative studies, C1q has been implicated in the pathogenesis of Erythema Nodosum Leprosum (ENL). However, little is known about the role of this complement in ENL reaction. Read More

    Effects of Vedolizumab Therapy on Extraintestinal Manifestations in Inflammatory Bowel Disease.
    Dig Dis Sci 2018 Apr 26;63(4):825-833. Epub 2018 Feb 26.
    Robarts Clinical Trials, Robarts Research Institute, Western University, 100 Dundas Street, Suite 200, London, ON, N6A 5B6, Canada.
    Background: Approximately 15-20% of ulcerative colitis patients and 20-40% of those with Crohn's disease experience extraintestinal manifestations (EIMs) of their inflammatory bowel disease (IBD). Clinicians who treat IBD must manage EIMs affecting multiple organs that variably correlate with intestinal disease activity. Vedolizumab is a monoclonal antibody for the treatment of IBD with a gut-selective mechanism of action. Read More

    The Effects of Prednisolone Treatment on Cytokine Expression in Patients with Erythema Nodosum Leprosum Reactions.
    Front Immunol 2018 9;9:189. Epub 2018 Feb 9.
    Faculty of Infectious Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.
    Erythema nodosum leprosum (ENL) is a systemic inflammatory complication occurring mainly in patients with lepromatous leprosy (LL) and borderline lepromatous leprosy. Prednisolone is widely used for treatment of ENL reactions but clinical improvement varies. However, there is little good data as to the effect of prednisolone treatment on the pro-inflammatory cytokines in patients with ENL reactions. Read More

    Erythema Nodosum Leprosum: Update and challenges on the treatment of a neglected condition.
    Acta Trop 2018 Feb 21;183:134-141. Epub 2018 Feb 21.
    Postgraduate Program in Genetics and Molecular Biology. Universidade Federal do Rio Grande do Sul, Av. Bento Gonçalves, 9500 - Prédio 43312 M, Porto Alegre, RS, Brazil; INAGEMP, Instituto Nacional de Genética Médica Populacional, R. Ramiro Barcelos, 2350 - 21506 - Santa Cecilia, Porto Alegre, RS, Brazil; Teratogen Information Service, Medical Genetics Service, Hospital de Clínicas de Porto Alegre, R. Ramiro Barcelos, 2350, Santa Cecília, Porto Alegre, RS, Brazil; Center of Experimental Research, Genomics Medicine Laboratory and Laboratory of Research in Bioethics and Ethics in Research (LAPEBEC), Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil. Electronic address:
    Erythema Nodosum Leprosum (ENL) occurs due to the immunological complication of multibacillary leprosy and is characterized by painful nodules and systemic compromising. It is usually recurrent and/or chronic and has both physical and economic impact on the patient, being a very important cause of disability. In addition, ENL is a major health problem in countries where leprosy is endemic. Read More

    Anti-interleukin 6 receptor tocilizumab in refractory uveitis associated with Behçet's disease: multicentre retrospective study.
    Rheumatology (Oxford) 2018 Feb 19. Epub 2018 Feb 19.
    Rheumatology Division and Epidemiology, Genetics and Atherosclerosis Research Group on Systemic Inflammatory Diseases, Hospital Universitario Marques de Valdecilla, IDIVAL, University of Cantabria, Santander, Spain.
    Objective: To assess the efficacy of tocilizumab (TCZ) in refractory uveitis of Behçet's disease (BD).

    Methods: Multicentre study of patients with BD-associated uveitis. Patients were refractory to conventional and biologic immunosuppressive drugs. Read More

    Differences Between Patients With Sarcoidosis With and Without Joint Involvement Treated for Fifteen Years in a Third Level Hospital.
    Reumatol Clin 2018 Feb 15. Epub 2018 Feb 15.
    Sección de Reumatología, Departamento de Medicina Interna, Hospital Pablo Tobón Uribe, Medellín, Colombia.
    Introduction: Sarcoidosis is a complex disease of unknown etiology, with a variable course and highly different forms of presentation. Our objective was to characterize all our patients with sarcoidosis with emphasis on their clinical presentation and to establish differences between patients with sarcoidosis with and without joint involvement.

    Methods: We reviewed the medical records of all patients with a diagnosis of sarcoidosis who were treated at the outpatient or inpatient services of the Pablo Tobón Uribe Hospital in Medellín, Colombia, from January 2002 to April 2017. Read More

    The cat did it: erythema nodosum and additional atypical presentations of infection in immunocompetent hosts.
    BMJ Case Rep 2018 Feb 16;2018. Epub 2018 Feb 16.
    Medicine, Laniado Hospital, Sanz Medical Centre, Netanya, Israel.
    A healthy patient presented with painful skin lesions on the anterior surface of her legs. Erythema nodosum was diagnosed but all the usual causes were ruled out. The finding of bilateral enlarged axillary lymph nodes with necrosis and granulomas led to the diagnosis of infection, an unusual cause of erythema nodosum. Read More

    Cytological Diagnosis of Erythema Nodosum Leprosum in Clinically Unsuspected Cases: A Report of Two Cases.
    J Cytol 2018 Jan-Mar;35(1):63-65
    Department of Pathology and Laboratory Medicine, AIIMS, Bhopal, Madhya Pradesh, India.
    Leprosy is a chronic infectious disease caused by . The manifestations of this disease varies across the spectrum of tuberculoid (TT) to lepromatous (LL) leprosy. The course of this indolent disease is interrupted by acute exacerbations in the form of leprare actions. Read More

    Acute myeloid leukemia presenting as erythema nodosum: A case report.
    Medicine (Baltimore) 2017 Nov;96(47):e8666
    Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
    Rationale: Erythema nodosum (EN), a type of septal panniculitis, could be a rare nonspecific cutaneous presentation of acute myeloid leukemia (AML).

    Patient Concerns: A 58-year-old Chinese female was admitted for a 4-week history of painful cutaneous lesions, accompanied by a sternal pain and fever. The lesions once resolved spontaneously but then recurred. Read More

    Incidence of diseases primarily affecting the skin by age group: population-based epidemiologic study in Olmsted County, Minnesota, and comparison with age-specific incidence rates worldwide.
    Int J Dermatol 2018 Jan 29. Epub 2018 Jan 29.
    Division of Clinical Dermatology, Mayo Clinic, Rochester, MN, USA.
    Understanding the effects of age on the epidemiology of diseases primarily affecting the skin is important to the practice of dermatology, both for proper allocation of resources and for optimal patient-centered care. To fully appreciate the effect that age may have on the population-based calculations of incidence of diseases primarily affecting the skin in Olmsted County, Minnesota, and worldwide, we performed a review of all relevant Rochester Epidemiology Project-published data and compared them to similar reports in the worldwide English literature. Using the Rochester Epidemiology Project, population-based epidemiologic studies have been performed to estimate the incidence of specific skin diseases over the past 50 years. Read More

    When nuisance is nice: ignored erythema nodosa heralding the Löfgren's syndrome in a Nigerian woman.
    Reumatologia 2017 28;55(5):261-264. Epub 2017 Oct 28.
    Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria.
    Löfgren's syndrome (LS) is a variant of sarcoidosis characterised by the triad of erythema nodosum (EN), radiographic bilateral hilar adenopathy, and arthralgia/arthritis. Like all cases of sarcoidosis, it is of unknown aetiology and may constitute a diagnostic difficulty in the ambiguous phenotype. Löfgren's syndrome is associated with a good prognosis and commonly undergoes spontaneous remission within four months. Read More

    Diagnostic contribution of magnetic resonance imaging in an atypical presentation of motor neuron disease.
    Quant Imaging Med Surg 2017 Dec;7(6):727-731
    Department of Advanced Biomedical Sciences, Neuroradiology Unit, University of Naples "Federico II", Naples, Italy.
    Motor neuron disease (MND) is a neurodegenerative disease determining progressive and relentless motor deterioration involving both upper and lower motor neurons (UMN and LMN); several variants at onset are described. Here we describe a case of MND presenting as pure spastic monoparesis in which magnetic resonance imaging (MRI) gave a substantial contribution in confirming the diagnosis and assessing the severity of UMN involvement. An isolated pyramidal syndrome, with complete absence of LMN signs, is a rare phenotype in the context of MND (less than 4% of total cases), especially if restricted to only one limb. Read More

    Skin and coeliac disease, a lot to think about: a case series.
    BMJ Case Rep 2018 Jan 4;2018. Epub 2018 Jan 4.
    Pediatric Department, Hospital of Divino Espírito Santo of Ponta Delgada, Ponta Delgada - São Miguel, Azores, Portugal.
    Coeliac disease (CD) is an autoimmune disease, characterised by a permanent sensitivity to gluten. It is being progressively recognised as a multisystemic disease, with multiple extraintestinal manifestations. Skin conditions (eg, dermatitis herpetiformis) are an example of its manifestations; however, its underlying mechanisms are still not well understood. Read More

    Behçet's syndrome and focal segmental glomerulosclerosis with nephrotic syndrome - successful treatment with etanercept
    Clin Nephrol 2018 May;89(5):371-375
    Behçet's syndrome (BS) often presents with aphthous and genital ulcers, uveitis, and erythema nodosum. Renal involvement has been reported with most cases presenting with renal amyloidosis, IgA nephropathy, or crescentic glomerulonephritis. We describe a case of a 49-year-old woman with relapsing BS symptoms coinciding with new-onset development of nephrotic syndrome. Read More

    Thalidomide and its analogues: A review of the potential for immunomodulation of fibrosis diseases and opthalmopathy.
    Exp Ther Med 2017 Dec 27;14(6):5251-5257. Epub 2017 Sep 27.
    Department of Ophthalmology, Daping Hospital and Research Institute of Surgery, The Third Military Medical University, People's Liberation Army, Chongqing 400042, P.R. China.
    The US Food and Drug Administration approved thalidomide and its analogues for the treatment of erythema nodosum leprosum, in spite of the notoriety of reports of severe birth defects in the middle of the last century. As immunomodulatory drugs, thalidomide and its analogues have been used to effectively treat various diseases. In the present review, preclinical data about the effects of thalidomide and its analogues on the immune system are integrated, including the effects of cytokines on transdifferentiation, the anti-inflammatory effect, immune cell function regulation and angiogenesis. Read More

    Elevated Pentraxin-3 Concentrations in Patients With Leprosy: Potential Biomarker of Erythema Nodosum Leprosum.
    J Infect Dis 2017 Dec;216(12):1635-1643
    Laboratório de Hanseníase, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil.
    Background: Leprosy, the leading infectious cause of disability worldwide, remains a major public health challenge in the most severely affected countries despite the sharp decline in new cases in recent years. The search for biomarkers is essential to achieve a better understanding of the molecular and cellular mechanisms underlying the disease.

    Methods: Pentraxin-3 (PTX3) analyses of sera from 87 leprosy patients with or without reactions were conducted via enzyme-linked immunosorbent assay. Read More

    Electrophysiological Study of Nerves in Type-II Reaction in Leprosy.
    Indian J Dermatol 2017 Nov-Dec;62(6):644-648
    Department of Medicine, BRD Medical College, Gorakhpur, Uttar Pradesh, India.
    Background: Leprosy is a chronic granulomatous infection primarily affecting the peripheral nervous system, skin and reticuloendothelial system. Cutaneous nerves are severely affected in lepra reaction and this leads to morbidity.

    Objective: To study electrophysiological pattern of different nerves involved in Type-II reactions in leprosy. Read More

    Increased activated memory B-cells in the peripheral blood of patients with erythema nodosum leprosum reactions.
    PLoS Negl Trop Dis 2017 12 18;11(12):e0006121. Epub 2017 Dec 18.
    London School of Hygiene and Tropical Medicine (LSHTM), Faculty of Infectious Tropical Diseases, London, United Kingdom.
    B-cells, in addition to antibody secretion, have emerged increasingly as effector and immunoregulatory cells in several chronic inflammatory diseases. Although Erythema Nodosum Leprosum (ENL) is an inflammatory complication of leprosy, the role of B- cell subsets has never been studied in this patient group. Therefore, it would be interesting to examine the contribution of B-cells in the pathogenesis of ENL. Read More

    Compression stockings as an effective treatment for erythema nodosum: Case series.
    Int J Womens Dermatol 2017 Dec 29;3(4):231-233. Epub 2017 Sep 29.
    Department of Medicine, Division of Dermatology, University of Arizona, Tucson, AZ.
    Erythema nodosum (EN) is a septal panniculitis that is characterized clinically by tender, erythematous, subcutaneous nodules that are predominately localized on the pretibial lower legs. EN affects women more than men and can be idiopathic or secondary to another disease process such as infection or an immune response. Treatment options for erythema nodosum are suboptimal and often involve significant side effects or require a change in lifestyle. Read More

    Expression Patterns of TNFα, MAdCAM1, and STAT3 in Intestinal and Skin Manifestations of Inflammatory Bowel Disease.
    J Crohns Colitis 2018 Feb;12(3):347-354
    Division of Gastroenterology and Hepatology, University Hospital Zurich, Switzerland.
    Background: Pathogenesis of cutaneous extraintestinal manifestations [EIM] in inflammatory bowel disease [IBD] remains elusive. Efficacy of anti-TNF agents suggests TNF-dependent mechanisms. The role of other biologics, such as anti-integrins or JAK-inhibitors, is not yet clear. Read More

    : An Unrecognized Cause of Fever of Unknown Origin in an Adult.
    Case Rep Infect Dis 2017 17;2017:6854913. Epub 2017 Oct 17.
    Internal Medicine Department, General Internal Medicine Division, Beaumont Health, Royal Oak, MI, USA.
    A 26-year-old female was admitted for fever of unknown origin (FUO), headaches, left ankle edema, and a lower extremity rash consistent with erythema nodosum. She had no respiratory symptoms or family history of autoimmune diseases. A chest X-ray was negative for pneumonia or hilar adenopathy. Read More

    Coexistence of idiopathic granulomatous mastitis and erythemanodosum: successful treatment with corticosteroids
    Turk J Med Sci 2017 11 13;47(5):1590-1592. Epub 2017 Nov 13.
    Background/aim: Idiopathic granulomatous mastitis (IGM) is a rare, chronic inflammatory disease of the breast. Erythema nodosum (EN) is a rare extramammary manifestation of IGM. The purpose of this study is to determine the clinical and demographic characteristics of 11 IGM and EN patients and to evaluate the efficacy of methylprednisolone treatment. Read More

    Leprosy Presenting with Iridocyclitis: A Diagnostic Dilemma.
    J Ophthalmic Vis Res 2017 Oct-Dec;12(4):437-439
    Department of Pathology, Uttar Pradesh University of Medical Sciences (U.P.U.M.S.), Saifai, Etawah, India.
    Purpose: To report a case of lepromatous iridocyclitis that posed a diagnostic challenge.

    Case Report: A 50-yeasr-old male developed profound loss of vision in the right eye, while he was in the hospital with septicemia presenting with fever, dysuria, and abdominal swelling. He also developed erythema nodosum on the legs. Read More

    Clinico-pathological features of erythema nodosum leprosum: A case-control study at ALERT hospital, Ethiopia.
    PLoS Negl Trop Dis 2017 Oct 13;11(10):e0006011. Epub 2017 Oct 13.
    London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom.
    Background: Leprosy reactions are a significant cause of morbidity in leprosy population. Erythema nodosum leprosum (ENL) is an immunological complication affecting approximately 50% of patients with lepromatous leprosy (LL) and 10% of borderline lepromatous (BL) leprosy. ENL is associated with clinical features such as skin lesions, neuritis, arthritis, dactylitis, eye inflammation, osteitis, orchitis, lymphadenitis and nephritis. Read More

    Case Report: Histoplasmosis in Himachal Pradesh (India): An Emerging Endemic Focus.
    Am J Trop Med Hyg 2017 Dec 21;97(6):1749-1756. Epub 2017 Sep 21.
    Department of Dermatology, Venereology and Leprosy, Dr. R. P. Govt. Medical College, Kangra (Tanda), Himachal Pradesh, India.
    We describe four cases of histoplasmosis indigenous to Himachal Pradesh (India) that will be of considerable public health interest. A 48-year-old human immunodeficiency virus (HIV)-negative man with cervical and mediastinal lymphadenopathy, hepatosplenomegaly, adrenal mass, and bone marrow involvement was treated as disseminated tuberculosis without benefit. Progressive disseminated histoplasmosis was diagnosed from the fungus in smears from adrenal mass. Read More

    Skin Manifestations Associated with Autoimmune Liver Diseases: a Systematic Review.
    Clin Rev Allergy Immunol 2017 Dec;53(3):394-412
    Dermatologia Ente Ospedaliero Cantonale, Ospedale Regionale Bellinzona e Valli, Bellinzona, Switzerland.
    Autoimmune liver diseases, which include mainly autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis, and the variant syndromes, are often associated with extrahepatic autoimmune diseases. However, the association with cutaneous diseases is less well described. In the present article, we provide a systematic literature review on skin manifestations linked to each of these four autoimmune liver diseases, excluding skin manifestations of systemic diseases. Read More

    T-cell regulation in Erythema Nodosum Leprosum.
    PLoS Negl Trop Dis 2017 Oct 9;11(10):e0006001. Epub 2017 Oct 9.
    London School of Hygiene and Tropical Medicine (LSHTM), Faculty of Infectious Tropical Diseases, London, United Kingdom.
    Leprosy is a disease caused by Mycobacterium leprae where the clinical spectrum correlates with the patient immune response. Erythema Nodosum Leprosum (ENL) is an immune-mediated inflammatory complication, which causes significant morbidity in affected leprosy patients. The underlying cause of ENL is not conclusively known. Read More

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