结核相关结节性红斑的研究进展

结节性红斑(erythema nodosum,EN)是一种常见的间隔性脂膜炎,以红斑、炎症性皮下结节为主要表现。其病因复杂,目前认为部分EN与结核菌感染关系密切。结核相关EN好发于女性及青少年,最常见的结核病类型是原发型结核和淋巴结结核,但大多数患者缺乏相应结核病表现。其发病机制认为与免疫复合物介导的以及细胞介导的免疫机制有关。EN主要根据皮损病理诊断确诊,其组织学表现为不伴血管炎的间隔性脂膜炎,多有间隔增厚,伴各种炎性细胞浸润。当怀疑结核菌感染时,则需完善结核菌素试验、结核抗体、胸片、痰培养等相关检查以明确诊断。认为即使缺乏明确的结核感染证据,对于结核菌素皮肤试验强阳性的患者,尤其是在结核流行病区,应该进行抗痨治疗。     

结核变态反应性结节性红斑临床及实验室观察

结核变态反应性结节性红斑临床及实验室观察薛智安，叶云红，杨河清太原钢铁公司总医院皮肤科（邮政编码０３０００３）我们自１９８９年７月～１９９４年７月，以结核变态反应性观察６４例结节性红斑，报告如下。临床资料１．一般情况：男１０例，女５４例，男女之比１：...     

下肢红斑结节性皮损与结核关系的探讨

目的 了解下肢红斑结节性皮损与结核的关系。方法 对50例下肢红斑结节性皮损的患者进行结核菌素及X线胸片检查。结核菌素试验强阳性者进行抗结核治疗。结果 结核菌素试验强阳性的有42例，占总数的84.0%。其中10例有明确肺结核病史。经抗结核治疗后41病例1月内明显好转，2月内原发皮损消退而痊愈。无肺结核的患者疗程为3个月，有肺结核者疗程为6个月。所有病例治疗完成后，半年内未见复发。结论 结核杆菌感染可能是下肢红斑结节性皮损最常见的原因。     

结节性红斑81例临床分析

目的探讨结节性红斑(EN)的临床特征、实验室检查及其病因。方法将81例患者据其基础疾病分为原发性和继发性两组,将其临床资料进行回顾性对比分析。结果81例患者中上呼吸道感染者35例(43.21%),关节炎表现24例(29.63%),结核菌素试验(PPD)异常者22例(27.16%),ASO滴度异常者27例(33.33%),血常规WBC计数异常者36例(44.44%),两组原发性EN和继发性EN比较,差异有显著性意义。结论继发性EN的病因与上呼吸道感染、结核杆菌及链球菌感染有密切关系,注重结节性红斑临床表现及实验室检查的差异,有助于寻找病因和治疗。     

结节性红斑患者红细胞指数改变

结节性红斑患者红细胞指数改变李冠勇，刘华昌，季军捷济南军区总医院皮肤科（邮政编码２５００３１）结节性红斑患者存在着血液流变学异常已有报道［１］。为了解本病患者红细胞变化的特点，我们采用ＳｙｓｍｅｘＦ－８００血细胞分析仪对结节性红斑患者的红细胞四项指数...     

结节性红斑女性因素的临床分析

结节性红斑女性因素的临床分析张堂德，曹化琴，邱贤文，梁应权结节性红斑好发于女性，女性在不同年龄有不同的生理性变化。目前尚没有报道充分说明这些生理变化是否与结节性红斑的产生与发展有关。本文从临床上探讨４１例女性结节性红斑与多种女性因素之间的关系。１．临...     

结节性红斑的诊疗进展

结节性红斑是以皮下脂肪炎症反应为特征的炎症性疾病,临床表现为双下肢疼痛性红斑。病因主要包括特发性、感染、自身免疫性疾病、妊娠、药物、肿瘤等。相关检查包括皮损活检、血沉、抗“O”、结核试验、胸片、血常规等。应该对症对因治疗。如非甾体抗炎药、糖皮质激素、碘化钾、沙利度胺等免疫抑制剂可以用于严重难治性病例。中医中药治疗及物理治疗也有较好疗效。     

结节性红斑与结核病的关系探讨

为探讨结节性红斑与结核病的关系,回顾分析56例结节性红斑病例的PPD试验、抗结核抗体结果,并与40例正常人做对照。结果:结节性红斑组的PPD试验强阳性率与正常对照组比较有显著差异,结节性红斑组的抗结核抗体的阳性率与正常对照组比较无显著差异,对PPD试验强阳性的结节性红斑患者,单纯抗结核治疗具有肯定疗效。结节性红斑与结核病的关系密切,抗结核治疗对于结核及其诱发的结节性红斑具有重要意义。     

33例脂膜炎与结核感染相关性分析

 目的 了解不同类型的脂膜炎患者与结核感染的相关性。方法 纳入2019年1月—2021年12月就诊于常德市第一人民医院33例脂膜炎患者的临床资料,对其临床特征、病理特征、与结核感染的相关性、治疗情况及随访情况进行分析。结果 ①33例脂膜炎患者中,结节性红斑24例,硬红斑9例,男女比例为1 ∶ 4.5,平均年龄46岁,平均病程10个月。②临床发病部位集中在四肢,均伴有疼痛。30例（90.91%)表现为红斑、结节、肿胀,其中1例硬红斑（3.03%）出现溃疡。6例(18.18%)出现发热、咳嗽、盗汗。2例硬红斑患者同时伴有或先后出现丘疹性坏死性结核疹,2例结节性红斑患者伴有全身多关节疼痛。③22例（66.67%,包括9例硬红斑、13例结节性红斑)伴结核分支杆菌潜伏感染（LTBI）。硬红斑患者结核感染阳性率高于结节性红斑患者（P＝0.020）。④皮损组织病理表现为间隔性脂膜炎11例、小叶性脂膜炎3例、混合性脂膜炎19例。与结核感染相关的22例脂膜炎患者病理下多可见上皮细胞肉芽肿、多核巨细胞以及干酪样坏死,其余11例均可见真皮层血管周围及脂肪间隔淋巴细胞浸润,且均未见上皮样肉芽肿及多核巨细胞。33例患者抗酸染色、PAS染色、直接免疫荧光均未见阳性表现。⑤22例与结核感染相关患者中,接受抗结核治疗15例,治愈率为68.18%,拒绝接受抗结核治疗患者7例,治愈率为14.29%。11例结核感染不相关患者采用免疫调节联合治疗,治愈率为100%。所有患者均未出现严重药物不良反应。结论 硬红斑患者的结核感染阳性率比结节性红斑患者高。在结核感染相关的脂膜炎患者中,接受抗结核治疗者治愈率比免疫调节联合治疗者高;对于未发现结核感染证据的结节性红斑,免疫调节治疗可能有效。结节性红斑患者的发病原因可能与结核感染相关。在结核高发地区,结节性红斑患者完善相关筛查极其重要。     

慢性结节性红斑1例

患者女,36岁.因双小腿结节、斑块及触痛4个月,于2010年2月28日到我科就诊.患者4个月前无明显诱因先后于两小腿出现板栗大红色结节,疼痛不明显,触之稍痛,未引起重视.     

Primary tuberculosis cases presenting with erythema nodosum

Erythema nodosum (EN) is seen only in the primary tuberculosis (TB) form of tuberculous diseases. Among the etiologies of EN, TB is the most frequent disorder in developing countries. We aimed to assess our patients with EN in reference to primary TB. We evaluated 335 patients with the diagnosis of TB during last 20 years; retrospectively 61 (18%) of these cases had pulmonary and 274 (82%) had extrapulmonary TB. Ten (16%) of the pulmonary TB cases were primary. All 10 patients with primary TB presented with EN. Among 50 patients with EN diagnosed and followed during the last 10 years, the etiology was determined in 56%, and primary TB was the most frequent: 20%.     

Three cases of erythema nodosum associated with Yersinia enterocolitica infection

Three cases of erythema nodosum associated with Yersinia enterocolitica infection were reported. They were diagnosed as Yersinosis following isolation of Yersinia enterocolitica from the feces and from serological investigation. The diagnosis was supported by the fact that Yersinia enterocolitica could be separated from the feces at an early stage of infection and that the serum agglutination titer for Yersinia enterocolitica increased within a month of infection. Clinically, the erythema nodosum preceded by abdominal pain and/or diarrhea was a complication of Yersinosis.     

Pentoxifylline in the treatment of erythema nodosum leprosum

Erythema nodosum leprosum (ENL) is a well-known serious complication affecting 10% of lepromatous multibacillary leprosy patients. In the chronic form, its morbidity may be considerable. Thalidomide and systemic steroids are the two current effective drugs for the management of ENL. However, their use in endemic countries is often difficult and hazardous, and a search for new therapies is needed. We report our experience on the effects of pentoxifylline, a methylxanthine derivative, which has recently been suggested as a possible effective treatment for ENL attacks.     

伴结节性红斑的大动脉炎2例临床及组织病理分析并文献复习

报告2例伴结节性红斑的大动脉炎。例1.患者女,43岁。例2.患者女,21岁。二例患者均因双下肢反复出现结节性红斑就诊,其中例2有间断发热。皮肤科检查：二例患者双下肢均可见散在结节性红斑。二例患者皮损组织病理检查均提示血管周围少许单核细胞或淋巴细胞浸润,皮下脂肪间隔增宽,胶原增生,部分脂肪细胞变性坏死,呈混合性脂膜炎改变。计算机断层摄影血管造影术（CTA）提示2例患者血管管腔均有不同程度的狭窄,例1患者狭窄部位位于头臂干、双侧颈动脉及锁骨下动脉,例2患者位于左锁骨下动脉。诊断：大动脉炎。     

Exploring the combination of SSKI and topical heparin in a case of erythema nodosum migrans

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. The patient was diagnosed initially and treated as a case of furunculosis with poor clinical response. The skin biopsy showed features consistent with subacute nodular panniculitis. Saturated Solution of Potassium Iodide along with topical Heparin successfully treated the patient, when the conventional treatment modalities failed. In a morpheaform centrifugally expanded plaque, erythema nodosum migrans should be kept in mind in the differential diagnosis, especially in the lower extremities in cases of unknown etiology.     

结节性红斑患者血清总IgE和MAO水平测定

目的：检测结节性红斑患者血清总IgE和单胺氧化酶（MAO）含量。方法：选择结节性红斑患者115例及正常人36名,应用化学发光免疫分析仪和全自动生化分析仪分别检测其血清总IgE和MAO。结果：结节性红斑患者血清总IgE含量235．36±295．14IU／mL高于健康对照组83．19±82．52IU／mL（P〈0．05）,血清MAO含量15．55±14．32U／L高于健康对照组7．43±3．76U／L（P〈0．01）。结论：IgE和MAO可能参与了结节性红斑的发病过程。     

Tinea barbae associated with erythema nodosum in an immunocompetent man.

We describe the case of a 45-year-old man with atopy who developed marked inflammatory lesions on the bearded area of the face caused by Tricophyton rubrum, an anthropophilic fungus not frequently correlated with kerion of the face. After starting therapy with griseofulvin, he developed typical lesions of erythema nodosum on both legs. We discuss how these lesions could be correlated with the kerion of the face.     

Erythema nodosum and erythema induratum (nodular vasculitis): diagnosis and management

Erythema nodosum is the most common type of panniculitis; it may be due to a variety of underlying infectious or otherwise antigenic stimuli. The pathogenesis remains to be elucidated, but both neutrophilic inflammation and granulomatous inflammation are implicated. Beyond treating underlying triggers, therapeutic options consist mainly of nonsteroidal anti‐inflammatory drugs, symptomatic care, potassium iodide, and colchicine. Erythema induratum (nodular vasculitis) is a related but distinctly different clinicopathologic reaction pattern of the subcutaneous fat. It is classically caused by an antigenic stimulus from Mycobacterium tuberculosis but may be associated with several other underlying disorders. After appropriate antimicrobial treatment in tuberculous cases, therapy for erythema induratum is similar to options for erythema nodosum.