Erytheme noueux: Quelle enquete etiologique?

ABSTRACT

Erythema nodosum has been described in association with a number of diseases setting a problem of etiologic diagnosis. Patients and We have evaluated 96 erythema nodosum hospitalized between 1987 and 1995 in 7 medical centers with a follow up of 23 weeks. 59% of patients were less than 40 years old.92% were females. lesions were bilateral in 95% of cases. Legs were interessed in all cases and arms in 23%. Presenting most often in spring and autumn [63%]. Fever [50%], arthrlagias [68%], arthritis [18%] and biologic inflammatory syndrome have no value of etiologic orientation. Streptococcemia [n = 28], iatrogenic causes [n = 8], Behcet disease [n =7], tuberculous and non tuberculous mycobact‚rias - except leprosy - [n = 5], pregnancy [n =2], ulcerative colitis [n= 1], Takayasu disease [n = 1] and IgA nephropathy [n =1] were causes founded. In 43 cases [44%] no etiology was determined. Precise and oriented medical interview and physical examination, search of micorscopiq hematuria, chest radiograph, intradermal test for tuberculin, determination of antistreptodornases B, search of mycobacterias in sputum is adequat in majority of cases for etiologic investigations