Aim: To study the etiology of Erythema nodosum (EN) and co-morbidities associated with it among a subset of Indian patients, clinical variation between idiopathic and secondary EN and also to assess the factors predictive for the development of EN.

Method: A cross sectional study was done on thirty patients with EN diagnosed on clinical basis. Patients were subjected to clinical examination, laboratory & radiological investigations including histopathology. Etiology of EN & associated co-morbidities were evaluated. Also the clinical variation between idiopathic and secondary EN was assessed.

Result: The frequency of unknown cause(Idiopathic EN) in our study was56.7%.The etiology could be determined in 43.3% of cases:- Streptococcal infection (23.1%), Tuberculosi s(15.4%), Drugs (15.4%), Pregnancy (15.4%), Behcet’s disease (15.4%), Sarcoidosis (7.7%), Inflammatory bowel disease (7.7%). 83.3% of the total patients were female & the mean age was 28.18 years in the idiopathic EN and 27.23 years in secondary EN. Hypothyroidism was significantly associated with idiopathic EN. We found significant differences between the idiopathic & secondary causes regarding history of fever within last 6 weeks, arthritis, cough, chest X ray abnormalities & ASO titre.

Conclusions: Etiological diagnosis was possible in 43.3% of cases. Most common cause was Streptococcal infection. Most of the cases were female. Idiopathic EN was significantly associated with hypothyroidism. Features like history of fever within last 6 weeks, arthritis, cough, chest X ray abnormalities &ASO titre were predictors of secondary EN. We compared our study results with other studies & emphasize the need of a detailed workup for all patients of EN because it’s harbinger of common and treatable conditions.

Keywords: Erythema nodosum, Tuberculosis, Sarcoidosis, Behcet’s disease.

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Dr Indranil Sen

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