Summary
Definition
History and exam
Key diagnostic factors
- presença de fatores de risco
- nódulos nas canelas
- uveíte, olhos vermelhos, nódulos retinianos ou gotas de vela
- nódulos em outras áreas cutâneas
- lesões cutâneas anestésicas
Other diagnostic factors
- dores nas articulações
- febre
- diarreia, constipação, dor abdominal, hematoquezia
- baço aumentado
- nódulos miliares na retina
Risk factors
- infecção por estreptococos
- sarcoidose
- tuberculose
- coccidioidomicose
- histoplasmose
- blastomicose
- brucelose
- Doença de Behçet
- contraceptivos orais
- sulfonamidas
- iodetos e medicamentos antiepilépticos
- psitacose
- lepra
- doença inflamatória intestinal
- gestação
- neoplasia maligna
Diagnostic tests
1st tests to order
- Hemograma completo
- título de antiestreptolisina O
- radiografia torácica
- teste tuberculínico, teste de liberação de gamainterferona
Tests to consider
- nível sérico de enzima conversora da angiotensina (ECA)
- biópsia de lesão cutânea
- teste cutâneo de coccidioidina
- teste cutâneo de histoplasmina
- teste cutâneo de lepromina
- sorologia para blastomicose
- sorologia para brucelose
- sorologia para psitacose
- raio-x das articulações sintomáticas
- teste do fator reumatoide
- título de aglutinação para Yersinia
- coproculturas para Yersinia
- colonoscopia
- imunoglobulina D (IgD) sérica
- biópsias por punção profunda incluindo gordura subcutânea, ou biópsias incisionais
Treatment algorithm
sintomas leves a moderadamente graves
sintomas refratários graves
Contributors
Authors
Daniela Kroshinsky, MD, MPH
Associate Professor of Dermatology
Harvard Medical School
Director of Pediatric Dermatology
Director of Inpatient Dermatology
Massachusetts General Hospital
Boston
MA
Disclosures
DK declares that she has no competing interests.
Acknowledgements
Dr Daniela Kroshinsky would like to gratefully acknowledge Dr Om P. Sharma, a previous contributor to this topic. Dr Kroshinsky would also like to thank Priyanka Vedak for her contribution to this topic. We would like to gratefully acknowledge the contribution of the late Elisabeth Higgins (Consultant Dermatologist, King’s College Hospital) for her peer review of this topic.
Disclosures
OPS declared that he had no competing interests. PV declared that she had no competing interests. EH declared that she had no competing interests.
Peer reviewers
Robert T. Brodell, MD
Professor of Internal Medicine
Clinical Professor of Dermatopathology
Northeastern Ohio Universities College of Medicine
Warren
Associate Clinical Professor of Dermatology
Case Western Reserve University School of Medicine
Cleveland
OH
Disclosures
RTB declares that he has no competing interests.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Bondi EE, Margolis DJ, Lazarus ZS. Panniculitis. In: Freedberg I, Eisen A, Wolff K, et al, eds. Fitzpatrick's dermatology in general medicine. 5th ed. New York, NY: McGraw-Hill; 1999: 1284-6.
Requena L, Requena C. Erythema nodosum (review). Dermatol Online J. 2002 Jun;8(1):4. Abstract
Sterling JB, Heymann WR. Potassium iodide in dermatology: a 19th century drug for the 21st century-uses, pharmacology, adverse effects, and contraindications. J Am Acad Dermatol. 2000 Oct;43(4):691-7. Abstract
Friedman ES, LaNatra N, Stiller MJ. NSAIDs in dermatologic therapy: review and preview. J Cutan Med Surg. 2002 Sep-Oct;6(5):449-59. Abstract
Schultz E, Whiting D. Treatment of erythema nodosum and nodular vasculitis with potassium iodides. Br J Dermatol. 1976 Jan;94(1):75-8. Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Doença de Weber-Christian
- Deficiência de alfa 1-antitripsina
- Vasculite nodular (eritema induratum ou doença de Bazin)
More Differentials
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