Fernandes N C, Maceira J, Muniz M de M
Faculdade de Medicina, Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Brasil.
Rev Inst Med Trop Sao Paulo. 1994 Nov-Dec;36(6):507-13. doi: 10.1590/s0036-46651994000600006.
The results of 32 cases studied lead us to the conclusion that erythema nodosum's investigation routine is very important, once in our retrospective study, the percentage of cases of unknown etiology was 69.4%, and in this prospective study it is 21.8%. In 10 cases (31.2%), more than one causing agent was suspected. Infections (bacterial, helminthic, fungal, by protozoa) were diagnosed in 26 cases, streptococcal infection having predominated (12 cases). Drugs-dipirone, aspirin, anovulatory--were suspected as causing agents in 13 cases. The association of erythema nodosum and histoplasmosis capsulata is described for the first time in Brazil. We consider erythema nodosum to be a complex syndrome which should be regarded as a manifestation of underlying diseases. The fact that all 32 subjects were women, 26 of them during menacme, suggests that particular hormonal media may favor the action of various processes (infections and drugs), precipitating erythema nodosum's clinical picture.
对32例病例的研究结果使我们得出结论,结节性红斑的常规检查非常重要。在我们的回顾性研究中,病因不明的病例占69.4%,而在这项前瞻性研究中这一比例为21.8%。在10例病例(31.2%)中,怀疑有不止一种致病因素。26例诊断为感染(细菌、蠕虫、真菌、原生动物),其中链球菌感染占主导(12例)。13例怀疑药物(双氯芬酸、阿司匹林、无排卵药)为致病因素。巴西首次描述了结节性红斑与荚膜组织胞浆菌病的关联。我们认为结节性红斑是一种复杂的综合征,应被视为潜在疾病的一种表现。所有32名受试者均为女性,其中26名处于月经期,这一事实表明特定的激素介质可能有利于各种过程(感染和药物)的作用,促使结节性红斑临床表现的出现。