Min Michelle S, Fischer Rob, Fournier John B
Boston University School of Medicine, Office of Student Affairs, 72 East Concord Street, A2, Boston, MA 02118, USA.
Department of Dermatology, Roger Williams Medical Center, 50 Maude Street, Providence, RI 02908, USA.
Case Rep Obstet Gynecol. 2016;2016:5726416. doi: 10.1155/2016/5726416. Epub 2016 Mar 27.
Erythema nodosum is a septal panniculitis that typically presents as symmetric, tender nodules on the anterior aspects of bilateral lower extremities. Nearly half of cases are due to secondary causes, with oral contraceptive pills being the leading pharmaceutical cause. However, to our knowledge, there has yet to be a published association with norethindrone acetate, ethinyl estradiol, and ferrous fumarate. We report our experience with a 30-year-old woman who developed unilateral tender nodules within a month of starting 1 mg norethindrone acetate and 20 mcg ethinyl estradiol daily. Of note, she had previously taken oral contraceptives with the same estrogen agent but different progesterone, without problems. We conclude that systemically triggered erythema nodosum can present with lesions localized to one extremity. When a patient presents with tender, firm nodules, clinicians should consider the possibility of erythema nodosum and its triggers, such as oral contraceptives. Additionally, should a patient on hormonal therapy develop erythema nodosum, changing the progesterone agent may allow the patient to continue similar therapy without developing symptoms.
结节性红斑是一种间隔性脂膜炎，通常表现为双侧下肢前部对称、触痛性结节。近一半的病例由继发性病因引起，口服避孕药是主要的药物性病因。然而，据我们所知，尚未有关于醋酸炔诺酮、炔雌醇和富马酸亚铁之间关联的报道。我们报告了一名30岁女性的病例，她在开始每日服用1毫克醋酸炔诺酮和20微克炔雌醇后的一个月内出现了单侧触痛性结节。值得注意的是，她之前服用过含有相同雌激素成分但不同孕激素的口服避孕药，未出现问题。我们得出结论，系统性引发的结节性红斑可表现为局限于一个肢体的病变。当患者出现触痛性、坚实的结节时，临床医生应考虑结节性红斑及其触发因素的可能性，如口服避孕药。此外，如果接受激素治疗的患者出现结节性红斑，更换孕激素成分可能使患者能够继续类似治疗而不出现症状。
