Background: The studies of series of children with erythema nodosum (EN) ar
e limited and mostly retrospective.
Objective: We evaluated the epidemiology; etiology, clinical manifestations
, course, and prognosis of EN in children.
Methods: Thirty-five children with EN (17 boys, 18 girls; mean age, 8.79) e
ars) have been studied. Four excluded children proved, on biopsy: to have l
eukocytoclastic vasculitis (n = 3) or eosinophilic cellulitis (n = 1)
Results: In 27 of the 35 children (77%), the etiology of EN was established
by laboratory investigations. In 25 children the causative factor of EN wa
s an infectious agent (including beta -hemolytic streptococcus [n = 17], an
d Mycobacterium tuberculosis [n = 2]), whereas in 2 patients, EN was associ
ated with Crohn's disease in one and Hodgkin's disease in the other. In 8 o
f the 35 children (23%) the etiology of EN remained undetermined. The mean
duration of the rash was 11.5 days. Recurrences were noted in only 2 childr
en (1 episode in 1 child and 3 episodes in the other).
Conclusion: Currently the most common provoking agent of EN in children in
Greece is beta -hemolytic streptococcus. However, Mycobacterium tuberculosi
s should still be considered as a cause of the disorder. Also, the course o
f EN is benign and recurrences are exceptional.