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    1 OF 87

    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 ofinfection 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 ofinfection, 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 Jan 2. Epub 2018 Jan 2.
    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 2017 Nov 22. Epub 2017 Nov 22.
    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

    Azathioprine in Chronic Recalcitrant Erythema Nodosum Leprosum: A Case Report.
    J Clin Diagn Res 2017 Aug 1;11(8):FD01-FD02. Epub 2017 Aug 1.
    Professor, Department of Pharmacology, Regional Institute of Medical Sciences, Imphal, Manipur, India.
    Erythema Nodosum Leprosum (ENL) may have a chronic course which may be recalcitrant to treatment. Preferred treatment modalities are systemic corticosteroids and thalidomide. Azathioprine, methotrexate and cyclosporine are immunosuppressants which may also be used as a steroid sparing agent. Read More

    New Insight into the Pathogenesis of Erythema Nodosum Leprosum: The Role of Activated Memory T-Cells.
    Front Immunol 2017 15;8:1149. Epub 2017 Sep 15.
    London School of Hygiene and Tropical Medicine, Faculty of Infectious Diseases, London, United Kingdom.
    Memory T-cells, particularly, effector memory T cells are implicated in the pathogenesis of inflammatory diseases and may contribute to tissue injury and disease progression. Although erythema nodosum leprosum (ENL) is an inflammatory complication of leprosy, the role of memory T cell subsets has never been studied in this patient group. The aim of this study was at investigate the kinetics of memory T cell subsets in patients with ENL before and after prednisolone treatment. Read More

    [Giardia duodenalis and its involvement in skin diseases].
    Ann Dermatol Venereol 2017 Nov 29;144(11):676-684. Epub 2017 Sep 29.
    Fondation Cheikh Khalifa Mohammed VI, Casablanca, Maroc; Faculté de médecine et de pharmacie, université Hassan II, Casablanca, Maroc.
    Backgound: Over the last thirty years, the scientific community has become increasingly interested in the intestinal flora, whether commensal or pathogenic, and its impact on other organs. In dermatology, the correlation between intestinal microbial agents and cutaneous lesions is well established. Giardia duodenalis, an intestinal parasite, has been particularly widely studied. Read More

    Takayasu arteritis presented with acute heart failure: case report and review of literature.
    ESC Heart Fail 2017 Nov 28;4(4):649-654. Epub 2017 Sep 28.
    Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
    Acute heart failure due to myocarditis is not common in Takayasu arteritis, let alone in combination with thrombosis affecting both ventricles and pulmonary arteries. The concomitant infection of non-tuberculosis mycobacterium further complicates the clinical scenario and poses challenges for implementation of tailored treatments. This case report describes a teenage girl with a history of intermittent claudication and Erythema Nodosum who developed acute heart failure. Read More

    Etanercept in erythema nodosum leprosum.
    An Bras Dermatol 2017 Jul-Aug;92(4):575-577
    Professor Rubem David Azulay Dermatology Institute, Santa Casa de Misericórdia do Rio de Janeiro (DPRDA-SCMRJ) - Rio de Janeiro (RJ), Brazil.
    One of the biggest challenges in treating leprosy is the control of reaction events. Patients with lepromatous leprosy may present reaction type II, or erythema nodosum leprosum, during treatment, and this reaction can remain in a recurrent form after being released from the hospital, requiring the use of thalidomide and/or prednisone for long periods of time, in turn increasing the risk of side effects. Two reports of the use of antiTNF to treat erythema nodosum leprosum were found in the literature. Read More

    A case of leprosy, erythema nodosum leprosum, and hemophagocytic syndrome: A continuum of manifestations of same agent-host interactions.
    Intractable Rare Dis Res 2017 Aug;6(3):230-233
    Department of Medicine, All India Institute of Medical Sciences, Delhi, India.
    A young adult man with 4-years history of lepromatous leprosy (received irregularly multidrug therapy) presented with two and half years history of symptoms suggestive of chronic erythema nodosum leprosum (ENL), initially responded to steroids and thalidomide, but later on failed. During the last 2-months, he developed fever, vomiting, and subsequently altered sensorium. On evaluation, he had hepatosplenomegaly, hyponatremia, hyperferritinemia, hemophagocytosis in bone marrow aspiration, lobular panniculitis in skin biopsy, and multiple parenchymal nodules in chest imaging. Read More

    Erythema nodosum-like panniculitis mimicking disease recurrence: A novel toxicity from immune checkpoint blockade therapy-Report of 2 patients.
    J Cutan Pathol 2017 Dec 13;44(12):1080-1086. Epub 2017 Oct 13.
    Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
    Immunotherapies targeting cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) and the programmed cell death 1 (PD-1) receptor and its ligand (PD-L1) have showed substantial therapeutic benefit in patients with clinically advanced solid malignancies. However, autoimmune toxicities are common and often significant adverse events with these agents. While rash and pruritus remain the most common cutaneous complications in treated patients, novel dermatologic toxicities related to immune checkpoint blockade continue to emerge as the number of patients exposed to immunotherapy increases. Read More

    Simultaneous analysis of multiple T helper subsets in leprosy reveals distinct patterns of Th1, Th2, Th17 and Tregs markers expression in clinical forms and reactional events.
    Med Microbiol Immunol 2017 Dec 5;206(6):429-439. Epub 2017 Sep 5.
    Centro de Ciências da Saúde, Universidade do Sagrado Coração, Rua Irmã Arminda, 10-50, Jardim Brasil, Bauru, São Paulo, 17.011-160, Brazil.
    Leprosy is a chronic infectious disease caused by Mycobacterium leprae. Previous studies have demonstrated that the difference among clinical forms of leprosy can be associated with the immune response of patients, mainly by T helper (Th) and regulatory T cells (Tregs). Then, aiming at clarifying the immune response, the expression of cytokines related to Th1, Th2, Th17 and Tregs profiles were evaluated by qPCR in 87 skin biopsies from leprosy patients. Read More

    Case of neutrophilic dermatosis as erythema nodosum migrans-like eruption with pustulosis in a patient with Crohn's disease.
    J Dermatol 2017 Dec 1;44(12):e338-e339. Epub 2017 Sep 1.
    Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

    Behçet's syndrome: providing integrated care.
    J Multidiscip Healthc 2017 14;10:309-319. Epub 2017 Aug 14.
    Division of Rheumatology, Department of Internal Medicine.
    Behçet's syndrome (BS) is a multisystem vasculitis that presents with a variety of mucocutaneous manifestations such as oral and genital ulcers, papulopustular lesions and erythema nodosum as well as ocular, vascular, gastrointestinal and nervous system involvement. Although it occurs worldwide, it is especially prevalent in the Far East and around the Mediterranean Sea. Male gender and younger age at disease onset are associated with a more severe disease course. Read More

    A case of Q fever with erythema nodosum.
    Infection 2018 Feb 17;46(1):127-129. Epub 2017 Aug 17.
    Department of Internal Medicine, Centre hospitalier universitaire de Poitiers, 2 Rue de la milétrie, 86000, Poitiers, France.
    Background: Acute Q fever is asymptomatic in 60% of the patients, while the reminder may present with fever, pneumoniae, and hepatitis. Skin manifestations are uncommon including transient punctiform rashes, purpuric, or maculopapular eruptions. Erythema nodosum have seldom been reported. Read More

    I Can Not Wear My Sunglasses: An Unusual Sarcoidosis Presentation.
    Korean J Fam Med 2017 Jul 20;38(4):226-228. Epub 2017 Jul 20.
    Department of Internal Medicine Unit, University Hospital Salamanca, Salamanca, Spain.
    A 39-year-old Caucasian man was referred to University Hospital Salamanca from a primary care unit due to the presence of an erythematous violaceous nodule at the superior portion of his nose. Physical examination indicated that the firm, fixed erythematous violaceous nodule measured approximately 2 cm in diameter and was located inferior to a scar on the nasal bridge. Cutaneous involvement in sarcoidosis occurs in 25% of cases. Read More

    Environmental sensitivity as a trigger of erythema nodosum and perimenopausal symptoms.
    BMJ Case Rep 2017 Aug 1;2017. Epub 2017 Aug 1.
    University of Arizona Center for Integrative Medicine, University of Arizona College of Medicine, Tucson, Arizona, USA.
    A 45-year-old woman presented to the University of Arizona Integrative Medicine Clinic for advice on managing recurrent erythema nodosum (EN), along with recent onset perimenopausal symptoms. Her painful EN flares had occurred two to six times per year over the past 14 years, yet had attenuated over the past 5 years until recently, and she presented with bilateral EN lesions on the shins. An environmental exposure history revealed that a new plastic-containing water pot had been introduced at her office just prior to her latest EN flare. Read More

    Bullous Erythema Nodosum Leprosum as the First Manifestation of Multibacillary Leprosy: A Rare Phenomenon.
    Am J Dermatopathol 2017 Nov;39(11):857-859
    Departments of *Histopathology, and †Dermatology, Sir Ganga Ram Hospital, Rajender Nagar, New Delhi, India.
    Erythema nodosum leprosum (ENL) may uncommonly present before treatment in patients with multibacillary leprosy. Atypical manifestations are known in ENL and may be clinically misleading. Such wide variations in the clinical presentation of leprosy in reaction make histopathology an important tool for supporting clinical diagnosis. Read More

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