Elsner J, Kiehl P, Kapp A, Weiss J
Dermatologische Klinik und Poliklinik, Medizinische Hochschule Hannover.
Hautarzt. 1996 Sep;47(9):701-4. doi: 10.1007/s001050050492.
A 35-year-old woman suffering from Crohn's disease for 3 years developed painful erythematous nodular lesions predominantly on the dorsa of her hands and feet, as well as on her elbows and wrists. The clinical features and histopathological picture of leukocytoclastic vasculitis were both highly suggestive of erythema elevatum diutinum. No improvement of the skin lesions was observed during treatment with high doses of oral steroids. In contrast, treatment with dapsone resulted in a marked reduction of skin lesions. During a new attack of her Crohn's disease the erythema elevatum diutinum lesions flared again. The parallel clinical course of erythema elevatum diutinum and Crohn's disease, as well as the detection of immune complexes and neutrophilic granulocytes in lesions of both diseases, strongly suggest a common etiology. This hypothesis is discussed in context with this case and the recent literature.
一名患有克罗恩病3年的35岁女性，主要在其手背、脚背以及肘部和腕部出现了疼痛性红斑结节性病变。白细胞破碎性血管炎的临床特征和组织病理学表现都高度提示持久性隆起性红斑。在高剂量口服类固醇治疗期间，皮肤病变未见改善。相比之下，氨苯砜治疗使皮肤病变明显减轻。在她的克罗恩病再次发作期间，持久性隆起性红斑病变再次发作。持久性隆起性红斑和克罗恩病的平行临床病程，以及在两种疾病的病变中检测到免疫复合物和嗜中性粒细胞，强烈提示存在共同病因。结合该病例和近期文献对这一假说进行了讨论。
