Friday, June 30, 2017

An 18-year-old woman presents to your office complaining of tender nodules that have developed on the lower extremities.

An 18-year-old woman presents to your office complaining of tender nodules that have developed on the lower extremities.


She has no other symptoms. She continues with her oral contraceptives but has not started any new medications. She denies any fevers and has no history of recent trauma.

The likely diagnosis is
A) Erythema multiforme
B) Erythema nodosum
C) Lyme disease
D) Pyoderma gangrenosum
E) Rheumatoid arthritis

Answer:
B. (Erythema nodosum)

Discussion: Erythema nodosum is an acute inflammatory reaction of the subcutaneous fat. Women between the ages of 20 and 30 years are most likely to be affected.

Causes include
use of oral contraceptives or sulfonamides,
pregnancy,
sarcoidosis,
histoplasmosis,
tuberculosis,
inflammatory bowel disease,
lymphoma,
leukemia,
Behçet’s disease, and
streptococcal infections.
Up to 40% of cases may be idiopathic.

Clinical features: Typically, the lesions begin as bright red, tender nodules. The lesions tend to occur bilaterally on the lower extremities and occasionally on the arms. Constitutional symptoms (fever, arthralgias, and malaise) may also be present. The lesions become dark brown or violaceous during the resolution phase. Spontaneous resolution occurs in 3 to 6 weeks after onset regardless of the cause.

Treatment consists of symptomatic treatment, nonsteroidal anti-inflammatory drugs, and systemic corticosteroids once an infectious cause is ruled out.

4 comments:

  1. I have been cured through Dr Utu African Traditional roots and herbs.
    Why so many people don't succeed in better health is because they have the belief that herbal medicines are primitive and outdated they took time ⌚ in thinking and having much doubt in herbs that can actually better their health naturally. Do you know that thinking and doubting won't solve your health problems?yes of course it won't solve it All you've to do is to stand up again and make the best move in your life. African herbs cures HIV, HSV, CANCERS, INFERTILITY, ASTHMA, PARALYSIS, DIABETES Try a reliable herbalist like Dr Utu and tell him your symptoms and feelings on;
    drutuherbalcure@gmail.com
    CALLING +2347032718477
    WHATSAPP LINE +2347032718477

    ReplyDelete
  2. Good day to all viewer online am so happy sharing this great testimony on how i was checking for solution in the internet then miraculously i came Across Dr.Aire the powerful herbalist that Cure Numerous individuals Herpes Simplex Virus,so I contacted him base on the testimonies I?m seeing about him on the internet, I was cured too by him, kindly contact him actoday through his email he can help you email ; drairehome@gmail.com OR WHATSAPP +2347036740271

    ReplyDelete
  3. I started on COPD Herbal treatment from Ultimate Health Home, the treatment worked incredibly for my lungs condition. I used the herbal treatment for almost 4 months, it reversed my COPD. My severe shortness of breath, dry cough, chest tightness gradually disappeared. Reach Ultimate Health Home via their website at www.ultimatelifeclinic.com I can breath much better and It feels comfortable!

    ReplyDelete
  4. The best casinos to play at the UK's top - JtmHub
    Best casinos to 광명 출장마사지 play at the UK's top. · Paddy Power 군산 출장안마 · Betfred · LeoVegas · William Hill 광명 출장마사지 · Paddy งานออนไลน์ Power · Caesars Sportsbook · BoyleSports · BoyleSports 군포 출장마사지

    ReplyDelete