Malaviya A N, Francis I M, Kaushik P, Ayyash E H
Department of Medicine, Faculty of Medicine, Kuwait University, Safat.
Rheumatol Int. 1999;19(1-2):51-7. doi: 10.1007/s002960050100.
The study describes 62 patients seen over a period of 4 years mainly presenting with an acute inflammatory ankle arthritis/periarthritis associated with panniculitis. Based upon the clinical characteristics of panniculitis two distinct categories could be defined. These included patients with characteristic lesions of erythema nodosum, seen in 51 (82%), the idiopathic form in 29 (57%), and secondary EN in 22 (43%). Associated conditions included Behçet's disease, oral contraceptive pills, pregnancy and penicillin treatment. Patients clinically not having typical EN was seen in 11 (18%). In this group the histopathology showed erythema induratum in 4, cutaneous-polyarteritis nodosa with minimal panniculitis in 3, Weber-Christian disease, cytophagic histiocytic panniculitis, and 'mixed' lobular and septal variety of panniculitis in 1 each. (In 1 patient the disease was not panniculitis but cutaneous variant of granuloma annulare). It is concluded that in a hospital setting EN associated with acute musculoskeletal symptoms, mainly ankle arthritis/periarthritis or an acute peripheral polyarthritis, was a common rheumatological problem in Kuwait. However, other forms of panniculitides also presented with musculoskeletal manifestations requiring accurate histopathological diagnosis for appropriate treatment.
该研究描述了在4年期间诊治的62例患者，这些患者主要表现为与脂膜炎相关的急性炎症性踝关节关节炎/关节周围炎。根据脂膜炎的临床特征可分为两个不同类别。其中包括51例（82%）出现特征性结节性红斑损害的患者，其中特发性形式的有29例（57%），继发性结节性红斑的有22例（43%）。相关情况包括白塞病、口服避孕药、妊娠和青霉素治疗。11例（18%）患者临床上未出现典型的结节性红斑。在这组患者中，组织病理学显示4例为硬结性红斑，3例为皮肤型结节性多动脉炎伴轻度脂膜炎，1例为韦格纳-克里斯蒂安病，1例为噬血细胞性组织细胞性脂膜炎，1例为小叶型和间隔型混合性脂膜炎。（1例患者疾病并非脂膜炎，而是环状肉芽肿的皮肤变型）。研究得出结论，在科威特的医院环境中，与急性肌肉骨骼症状相关的结节性红斑，主要是踝关节关节炎/关节周围炎或急性外周多关节炎，是一个常见的风湿病问题。然而，其他形式的脂膜炎也表现出肌肉骨骼症状，需要准确的组织病理学诊断以进行适当治疗。
