Erythema nodosum
Erythema nodosum is an inflammatory disease characterized clinically by symmetrical, bright red or purplish-red painful nodular lesions of the lower extremities, with pathological changes mainly manifesting as dermal vasculitis and inflammation of the lipid membranes. It can be an isolated disease or a manifestation of some systemic diseases. It is more common in young women, and certain men with systemic diseases (such as leukoaraiosis) may also have erythema nodosum-like manifestations, generally with the onset in spring and autumn. The causes are
1, infection. Among them, streptococcal infections, tuberculosis, intestinal infections, systemic fungal infections and viruses (pox virus, hepatitis virus, herpes-like virus) can be caused.
2, drugs. Such as sulfonamides, bromides, iodides, birth control pills, etc.
3.See certain systemic or visceral diseases, such as leukoaraiosis, acute febrile neutrophilic dermatosis, nodular disease, systemic lupus erythematosus, Kern disease, ulcerative colitis, leukemia and other malignancies.
4. About 50% of patients have no obvious cause.
The lesions are mainly symmetrically distributed on the front and both sides of the shins, and appear as painful nodules of bright red to dark red slightly elevated skin surface, 1-5 cm in diameter with smooth and shiny nodule surface, slightly edematous, scattered distribution without mutual fusion. They are usually seen in young women, with prodromal symptoms such as fever, headache, malaise, and muscle and joint pain before onset, and can be diagnosed by excluding other primary rheumatic diseases and confirmed by skin biopsy.
The onset of the disease is often slow, nodules are mainly located in the flexor side of the calf, usually 3-5, dark red, walnut size, hard texture, can be fused into a mass often can form ulcers, chronic course. Tuberculin test is strongly positive and biopsy confirms the diagnosis.
Erythema rigidum
It occurs mainly in young people and middle-aged people, and usually manifests as bilateral pulmonary hilar lymphadenopathy, pulmonary infiltrates and ocular and skin lesions, and its clinical characteristics are
1. Skin lesions often involve the trunk, extremities and scalp.
2, the rash is dark brown.
3. The erythema varies in size and shape.
4.The lesions have clear edges.
5.It may appear as painless, non-itchy subcutaneous nodules.
6.The onset of skin lesions varies from several months to several years.
7. The lesions often coexist with lung, eye and peripheral lymph node lesions.
Nodular disease
Recurrent oral and vulvar ulcers; ophthalmia; skin lesions; positive pinprick test.
Leukoplakia
Clinically characterized by fever, painful skin nodules and class lumps, and elevated peripheral blood neutrophils, the disease is self-limiting but can recur. The lesions begin as bright red papules or nodules, distributed bilaterally but asymmetrically, and soon expand into dark, dark red swollen plaques. Most patients have fever and discomfort, and some have arthralgia, conjunctivitis, and kidney damage. Biopsy confirms the diagnosis.
Acute febrile neutrophilic dermatosis
The lesions are subcutaneous nodules to large infiltrative masses, most often seen in women 30-60. The nodules have spontaneous pain or tenderness and develop slowly, but sometimes acutely, with erythema of the surface skin. Some nodules are arranged in a linear pattern, mostly without ulceration, and disappear after about 2-4 weeks or leave a fibrous nodule. Biopsy confirms the diagnosis.
Nodular vasculitis
Weight loss greater than or equal to 4 kg; reticular cyanosis; testicular pain or tenderness; myalgia, weakness, or lower extremity pain; mononeuropathy or polyneuropathy; systolic blood pressure greater than 90 mmHg; elevated BUN or Cr levels; established viral hepatitis; arteriographic abnormalities; polymorphonuclear cells on biopsy of small to medium-sized arteries. The diagnosis is made when three or more of these criteria are met.
Polyarteritis nodosa
Cheek erythema; discoid lupus; photosensitivity; oral ulcers; non-erosive arthritis; urine protein >0.5 g/d or urine cell tubularity; seizures or psychosis; pleurisy or pericarditis; hemolytic anemia or leukopenia or lymphocytopenia or thrombocytopenia; anti-ds-DNA antibody or anti-sm antibody or false positive seropositivity for LE cells or syphilis. The diagnosis is confirmed by meeting 4 or more of these criteria.