Erythema nodosum in Israeli children

Background: Erythema nodosum, although uncommon in children, is the most fr equent form of panniculitis in pediatrics. EN has been associated with vari ous infections and chronic inflammations, and its course varies with age, g ender, and racial and geographic factors. There is no information on EN in Israeli children. Objectives: To examine the clinical course of EN and the conditions with wh ich it is associated in Israeli children. Methods: We conducted a retrospective study of 24 children with a diagnosis of EN who presented at our Center over a 10 year period (1989-98). Results: EN was more frequent in females than males (ratio 2:1) due to a cl uster of adolescent girls. The mean duration of the skin manifestation was 18 days. The course was benign in all patients. Streptococcal infection was the most common cause (25%), followed by Epstein-Barr virus infection (18% ) and inflammatory bowel disease (13%). In one-third of cases, no specific cause could be identified. Tuberculosis, an important cause of EN in the pa st, was not found in our patients. Conclusions: Most cases of EN in Israeli children are related to streptococ cal and EBV infections or to chronic inflammatory conditions. Despite the i ncrease in tuberculosis morbidity in Israel during recent years, we found n o association of EN and tuberculosis in our study.