[单侧结节性红斑与同侧皮肤利什曼病]
[Unilateral erythema nodosum and homolateral cutaneous leishmaniasis].
作者信息
Youssef S, Hammami H, Cheffaï S, Dhaoui M R, Jaber K, Doss N
机构信息
Service de dermatologie, hôpital Militaire, 1089 Tunis, Tunisie.
出版信息
Med Mal Infect. 2009 Sep;39(9):739-40. doi: 10.1016/j.medmal.2009.02.005. Epub 2009 Apr 3.
OBJECTIVE
The authors wanted to report an uncommon etiology of erythema nodosum.
CASE REPORT
A 45-year-old woman presented with numerous encrusted nodular lesions on the left leg and arm. Leishmania was identified after a parasitological examination. Subcutaneous erythematous nodules developed later on the same leg. Erythema nodosum was diagnosed with a biopsy of the nodules. The patient was treated with systemic meglumine 60 mg/kg per day for 13 days. All lesions improved under treatment.
DISCUSSION
This was the first reported case of unilateral erythema nodosum with cutaneous leishmaniasis. Clinical and laboratory exams were in the range of normal and led the authors to exclude common causes of erythema nodosum. Subcutaneous nodules occurred before the beginning of treatment with meglumine. Thus, drug allergy (previously reported) was excluded as an etiology of EN.
目的
作者想要报告结节性红斑一种不常见的病因。
病例报告
一名45岁女性左腿和手臂出现大量结痂的结节性病变。经寄生虫学检查发现利什曼原虫。随后同一条腿上出现了皮下红斑结节。通过对结节进行活检诊断为结节性红斑。患者接受了每天60毫克/千克的系统性葡甲胺治疗，持续13天。所有病变在治疗后均有改善。
讨论
这是首例报告的伴有皮肤利什曼病的单侧结节性红斑病例。临床和实验室检查结果均在正常范围内，这使得作者排除了结节性红斑的常见病因。皮下结节在开始使用葡甲胺治疗之前就已出现。因此，排除了药物过敏（先前有报道）作为结节性红斑的病因。
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