Database : MEDLINE
Search on : erythema and nodosum [Words]
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[PMID]: 29028793
[Au] Autor:Negera E; Walker SL; Girma S; Doni SN; Tsegaye D; Lambert SM; Idriss MH; Tsegay Y; Dockrell HM; Aseffa A; Lockwood DN
[Ad] Address:London School of Hygiene and Tropical Medicine (LSHTM), London, United Kingdom.
[Ti] Title:Clinico-pathological features of erythema nodosum leprosum: A case-control study at ALERT hospital, Ethiopia.
[So] Source:PLoS Negl Trop Dis;11(10):e0006011, 2017 Oct.
[Is] ISSN:1935-2735
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Leprosy reactions are a significant cause of morbidity in leprosy population. Erythema nodosum leprosum (ENL) is an immunological complication affecting approximately 50% of patients with lepromatous leprosy (LL) and 10% of borderline lepromatous (BL) leprosy. ENL is associated with clinical features such as skin lesions, neuritis, arthritis, dactylitis, eye inflammation, osteitis, orchitis, lymphadenitis and nephritis. ENL is treated mainly with corticosteroids and corticosteroids are often required for extended periods of time which may lead to serious adverse effects. High mortality rate and increased morbidity associated with corticosteroid treatment of ENL has been reported. For improved and evidence-based treatment of ENL, documenting the systems affected by ENL is important. We report here the clinical features of ENL in a cohort of patients with acute ENL who were recruited for a clinico-pathological study before and after prednisolone treatment. MATERIALS AND METHODS: A case-control study was performed at ALERT hospital, Ethiopia. Forty-six LL patients with ENL and 31 non-reactional LL matched controls were enrolled to the study and followed for 28 weeks. Clinical features were systematically documented at three visits (before, during and after predinsolone treatment of ENL cases) using a specifically designed form. Skin biopsy samples were obtained from each patient before and after treatment and used for histopathological investigations to supplement the clinical data. RESULTS: Pain was the most common symptom reported (98%) by patients with ENL. Eighty percent of them had reported skin pain and more than 70% had nerve and joint pain at enrolment. About 40% of the patients developed chronic ENL. Most individuals 95.7% had nodular skin lesions. Over half of patients with ENL had old nerve function impairment (NFI) while 13% had new NFI at enrolment. Facial and limb oedema were present in 60% patients. Regarding pathological findings before treatment, dermal neutrophilic infiltration was noted in 58.8% of patients with ENL compared to 14.3% in LL controls. Only 14.7% patients with ENL had evidence of vasculitis at enrolment. CONCLUSION: In our study, painful nodular skin lesions were present in all ENL patients. Only 58% patients had dermal polymorphonuclear cell infiltration showing that not all clinically confirmed ENL cases have neutrophilic infiltration in lesions. Very few patients had histological evidence of vasculitis. Many patients developed chronic ENL and these patients require inpatient corticosteroid treatment for extended periods which challenges the health service facility in resource poor settings, as well as the patient's quality of life.
[Mh] MeSH terms primary: Erythema Nodosum/pathology
Erythema Nodosum/physiopathology
Leprosy, Lepromatous/pathology
Leprosy, Lepromatous/physiopathology
Skin/pathology
[Mh] MeSH terms secundary: Adolescent
Adrenal Cortex Hormones/adverse effects
Adrenal Cortex Hormones/therapeutic use
Adult
Biopsy
Case-Control Studies
Edema/etiology
Erythema Nodosum/drug therapy
Ethiopia/epidemiology
Extremities
Female
Hospitals
Humans
Leprosy, Borderline/complications
Leprosy, Lepromatous/complications
Leprosy, Lepromatous/microbiology
Male
Middle Aged
Neutrophil Infiltration
Pain
Quality of Life
Skin/drug effects
Skin/immunology
Skin/microbiology
Vasculitis/etiology
Vasculitis/pathology
Young Adult
[Pt] Publication type:JOURNAL ARTICLE
[Nm] Name of substance:0 (Adrenal Cortex Hormones)
[Em] Entry month:1711
[Cu] Class update date: 171102
[Lr] Last revision date:171102
[Js] Journal subset:IM
[Da] Date of entry for processing:171013
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pntd.0006011

  2 / 3649 MEDLINE  
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[PMID]: 28970261
[Au] Autor:Saltman AP; Kuriya B
[Ad] Address:Division of Rheumatology, Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, Ont. alexandra.saltman@gmail.com.
[Ti] Title:Löfgren syndrome in acute sarcoidosis.
[So] Source:CMAJ;189(39):E1230, 2017 10 02.
[Is] ISSN:1488-2329
[Cp] Country of publication:Canada
[La] Language:eng
[Mh] MeSH terms primary: Arthritis/etiology
Erythema Nodosum/etiology
Sarcoidosis/complications
[Mh] MeSH terms secundary: Acute Disease
Arthritis/diagnosis
Diagnosis, Differential
Erythema Nodosum/diagnosis
Female
Humans
Middle Aged
Sarcoidosis/diagnosis
Syndrome
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171102
[Lr] Last revision date:171102
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:171003
[St] Status:MEDLINE
[do] DOI:10.1503/cmaj.170547

  3 / 3649 MEDLINE  
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[PMID]: 28875310
[Au] Autor:Azevedo MCS; Marques H; Binelli LS; Malange MSV; Devides AC; Silva EA; Fachin LRV; Ghidella CC; Soares CT; Garlet GP; Rosa PS; Belone AFF; Trombone APF
[Ad] Address:Instituto Lauro de Souza Lima, Rodovia Comandante João Ribeiro de Barros, Km 225/226, Bauru, São Paulo, 17034-971, Brazil.
[Ti] Title:Simultaneous analysis of multiple T helper subsets in leprosy reveals distinct patterns of Th1, Th2, Th17 and Tregs markers expression in clinical forms and reactional events.
[So] Source:Med Microbiol Immunol;206(6):429-439, 2017 Dec.
[Is] ISSN:1432-1831
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:Leprosy is a chronic infectious disease caused by Mycobacterium leprae. Previous studies have demonstrated that the difference among clinical forms of leprosy can be associated with the immune response of patients, mainly by T helper (Th) and regulatory T cells (Tregs). Then, aiming at clarifying the immune response, the expression of cytokines related to Th1, Th2, Th17 and Tregs profiles were evaluated by qPCR in 87 skin biopsies from leprosy patients. Additionally, cytokines and anti-PGL-1 antibodies were determined in serum by ELISA. The results showed that the expression of various targets (mRNA) related to Th1, Th2, Th17 and Tregs were significantly modulated in leprosy when compared with healthy individuals, suggesting the presence of a mixed profile. In addition, the targets related to Th1 predominated in the tuberculoid pole and side and Th2 and Tregs predominated in the lepromatous pole and side; however, Th17 targets showed a mixed profile. Concerning reactional events, Tregs markers were decreased and IL-15 was increased in reversal reaction and IL-17F, CCL20 and IL-8 in erythema nodosum leprosum, when compared with the respective non-reactional leprosy patients. Additionally, ELISA analysis demonstrated that IL-22, IL-6, IL-10 and anti-PGL-1 antibody levels were significantly higher in the serum of patients when compared with healthy individuals, and IL-10 and anti-PGL-1 antibodies were also increased in the lepromatous pole and side. Together, these results indicate that Th1, Th2 and Th17 are involved in the determination of clinical forms of leprosy and suggest that decreased Tregs activity may be involved in the pathogenesis of reactional events.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1709
[Cu] Class update date: 171102
[Lr] Last revision date:171102
[St] Status:In-Process
[do] DOI:10.1007/s00430-017-0519-9

  4 / 3649 MEDLINE  
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[PMID]: 28502139
[Au] Autor:Fawzy RM; Said EA; Mohamed SM; Fouad NA; Akl EM
[Ad] Address:Department of Rheumatology and Rehabilitation, Faculty of Medicine, Benha University, Benha, Egypt.
[Ti] Title:Serum Interleukin-33 in Behcet's Disease: Its Relation to Disease Activity and Clinical Manifestations.
[So] Source:Egypt J Immunol;22(2):1-8, 2015 Jun.
[Is] ISSN:1110-4902
[Cp] Country of publication:Egypt
[La] Language:eng
[Ab] Abstract:Behcet's disease (BD) is a chronic systemic inflammatory disorder characterized by a course of remissions and exacerbations of unpredictable frequency and duration . Pro- inflammatory cytokines seem to be responsible for the enhanced inflammatory response in BD. AIM OF THE WORK: This study aimed to investigate serum levels of IL-33 in patients with Behcet's disease (BD) and their relationship to disease activity and clinical manifestations. Thirty patients with BD were enrolled and subjected to assessment of disease activity according to Behcet's Disease Current Activity Form (BDCAF) score. Serum IL-33 levels were determined using Enzyme-Linked-Immunosorbent Assay (ELISA). Thirty age and sex matched rheumatoid arthritis patients and thirty healthy volunteers were included in this study as control groups. Serum IL-33 level was 132.5±19 pg\ml, 101.2±20.1 pg\ml and 31.5±10.5 pg\ml in RA, BD and healthy control groups respectively. IL-33 was significantly higher in BD patients (101.2±20.1pg/ml) as compared to healthy controls (31.5±10.5 pg/ml) but lower than rheumatoid arthritis patients (132.5±19.1 pg/ml). Levels of IL-33 were significantly increased in BD patients with skin lesions (Erythema nodosum & Acneiform lesions) and ocular lesions (retinal vasculitis) (P<0.05), and a positive correlation was found between BDCAF score and IL-33serum levels (r=0.9, P<0.001). In conclusions, serum IL-33 level is elevated in active BD patients with skin and ocular affection and correlates with disease activity.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1705
[Cu] Class update date: 171101
[Lr] Last revision date:171101
[St] Status:In-Process

  5 / 3649 MEDLINE  
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[PMID]: 28965699
[Au] Autor:Humbert P; Guichard A; Bennani I; Chiheb S
[Ad] Address:Service de dermatologie, centre d'études et de recherche sur le tégument (CERT), centre d'investigation clinique (CIC BT506), université de Franche-Comté, centre hospitalier universitaire Besançon, Inserm UMR1098, SFR FED 4234 IBCT, 25030 Besançon, France; Fondation Cheikh Khalifa Mohammed VI, Casab
[Ti] Title:Giardia duodenalis et son implication dans diverses dermatoses. [Giardia duodenalis and its involvement in skin diseases].
[So] Source:Ann Dermatol Venereol;144(11):676-684, 2017 Nov.
[Is] ISSN:0151-9638
[Cp] Country of publication:France
[La] Language:fre
[Ab] Abstract:BACKGOUND: Over the last thirty years, the scientific community has become increasingly interested in the intestinal flora, whether commensal or pathogenic, and its impact on other organs. In dermatology, the correlation between intestinal microbial agents and cutaneous lesions is well established. Giardia duodenalis, an intestinal parasite, has been particularly widely studied. The aim of this work is to provide a review of studies demonstrating the involvement of G. duodenalis in various forms of dermatosis. PATIENTS AND METHODS: The data were obtained by an English-language literature search of Medline, PubMed and Google Scholar for the period 1975-2015. Among the thirty case reports since 1976, we selected the twenty most objective and clinically relevant. RESULTS AND DISCUSSION: This review demonstrates that intestinal giardiasis may be an etiological factor, either alone or in combination with other agents, of various dermatoses through inflammatory and allergic mechanisms or intestinal hyperpermeability. The mucocutaneous lesions are varied: urticaria, angioedema, atopic dermatitis, erythema nodosum, Wells syndrome, among others. The role and origin of the infection are often unknown, and it is thus difficult to determine the interval between parasite infestation and the onset of skin lesions. Consequently, a fecal examination to identify G. duodenalis should be considered in chronic urticaria or angioedema, and where atopic dermatitis occurs in adulthood without any specific etiology. Therapeutic test should be done in every suspicion.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE; REVIEW
[Em] Entry month:1710
[Cu] Class update date: 171027
[Lr] Last revision date:171027
[St] Status:In-Process

  6 / 3649 MEDLINE  
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[PMID]: 28763338
[Au] Autor:Bakshi N; Rao S; Batra R
[Ad] Address:Departments of *Histopathology, and †Dermatology, Sir Ganga Ram Hospital, Rajender Nagar, New Delhi, India.
[Ti] Title:Bullous Erythema Nodosum Leprosum as the First Manifestation of Multibacillary Leprosy: A Rare Phenomenon.
[So] Source:Am J Dermatopathol;39(11):857-859, 2017 Nov.
[Is] ISSN:1533-0311
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Erythema nodosum leprosum (ENL) may uncommonly present before treatment in patients with multibacillary leprosy. Atypical manifestations are known in ENL and may be clinically misleading. Such wide variations in the clinical presentation of leprosy in reaction make histopathology an important tool for supporting clinical diagnosis. We report bullous ENL presenting as the first manifestation of leprosy in a 30-year-old Indian man diagnosed using histopathology.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1708
[Cu] Class update date: 171020
[Lr] Last revision date:171020
[St] Status:In-Process
[do] DOI:10.1097/DAD.0000000000000887

  7 / 3649 MEDLINE  
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[PMID]: 28991896
[Au] Autor:Negera E; Walker SL; Bobosha K; Howe R; Aseffa A; Dockrell HM; Lockwood DN
[Ad] Address:London School of Hygiene and Tropical Medicine (LSHTM), Faculty of Infectious Tropical Diseases, London, United Kingdom.
[Ti] Title:T-cell regulation in Erythema Nodosum Leprosum.
[So] Source:PLoS Negl Trop Dis;11(10):e0006001, 2017 Oct.
[Is] ISSN:1935-2735
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Leprosy is a disease caused by Mycobacterium leprae where the clinical spectrum correlates with the patient immune response. Erythema Nodosum Leprosum (ENL) is an immune-mediated inflammatory complication, which causes significant morbidity in affected leprosy patients. The underlying cause of ENL is not conclusively known. However, immune-complexes and cell-mediated immunity have been suggested in the pathogenesis of ENL. The aim of this study was to investigate the regulatory T-cells in patients with ENL. Forty-six untreated patients with ENL and 31 non-reactional lepromatous leprosy (LL) patient controls visiting ALERT Hospital, Ethiopia were enrolled to the study. Blood samples were obtained before, during and after prednisolone treatment of ENL cases. Peripheral blood mononuclear cells (PBMCs) were isolated and used for immunophenotyping of regulatory T-cells by flow cytometry. Five markers: CD3, CD4 or CD8, CD25, CD27 and FoxP3 were used to define CD4+ and CD8+ regulatory T-cells. Clinical and histopathological data were obtained as supplementary information. All patients had been followed for 28 weeks. Patients with ENL reactions had a lower percentage of CD4+ regulatory T-cells (1.7%) than LL patient controls (3.8%) at diagnosis of ENL before treatment. After treatment, the percentage of CD4+regulatory T-cells was not significantly different between the two groups. The percentage of CD8+ regulatory T-cells was not significantly different in ENL and LL controls before and after treatment. Furthermore, patients with ENL had higher percentage of CD4+ T-ells and CD4+/CD8+ T-cells ratio than LL patient controls before treatment. The expression of CD25 on CD4+ and CD8+ T-cells was not significantly different in ENL and LL controls suggesting that CD25 expression is not associated with ENL reactions while FoxP3 expression on CD4+ T-cells was significantly lower in patients with ENL than in LL controls. We also found that prednisolone treatment of patients with ENL reactions suppresses CD4+ T-cell but not CD8+ T-cell frequencies. Hence, ENL is associated with lower levels of T regulatory cells and higher CD4+/CD8+ T-cell ratio. We suggest that this loss of regulation is one of the causes of ENL.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1710
[Cu] Class update date: 171019
[Lr] Last revision date:171019
[St] Status:In-Process
[do] DOI:10.1371/journal.pntd.0006001

  8 / 3649 MEDLINE  
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[PMID]: 28260712
[Au] Autor:Ihara Y; Hizawa K; Fujita K; Iida M; Washio E; Kai T; Nitahata T; Esaki M; Iida M
[Ad] Address:Department of Gastroenterology, Kyushu Central Hospital.
[Ti] Title:A case of Turner syndrome (46XXp-/45X) complicated with Crohn's disease after hormone therapy.
[So] Source:Nihon Shokakibyo Gakkai Zasshi;114(3):445-449, 2017.
[Is] ISSN:0446-6586
[Cp] Country of publication:Japan
[La] Language:jpn
[Ab] Abstract:A 19-year-old woman, who had been receiving hormone replacement therapy for 13 months before the diagnosis of mosaic Turner syndrome (46XXp-/45X), developed Crohn's colitis and erythema nodosum of the lower legs. Colonoscopy revealed an anal fistula and the presence of deep longitudinal ulcers with cobblestoning in the colorectum. Therapy with prednisolone and adalimumab was effective for the intestinal and skin lesions. To date, all seven case reports of Turner syndrome in Japan have also developed Crohn's disease after hormone therapy, suggesting a possible association of sex hormones in the pathogenesis.
[Mh] MeSH terms primary: Chromosomes, Human, X
Crohn Disease/etiology
Hormone Replacement Therapy/adverse effects
Turner Syndrome/complications
Turner Syndrome/drug therapy
[Mh] MeSH terms secundary: Colonoscopy
Crohn Disease/diagnostic imaging
Female
Humans
Tomography, X-Ray Computed
Young Adult
[Pt] Publication type:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Entry month:1710
[Cu] Class update date: 171018
[Lr] Last revision date:171018
[Js] Journal subset:IM
[Da] Date of entry for processing:170306
[St] Status:MEDLINE
[do] DOI:10.11405/nisshoshi.114.445

  9 / 3649 MEDLINE  
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[PMID]: 28130683
[Au] Autor:Takeuchi Y; Shigemura T; Kobayashi N; Kaneko N; Iwasaki T; Minami K; Kobayashi K; Masumoto J; Agematsu K
[Ad] Address:Department of Pediatrics, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, 390-8621, Japan. takeuchiyu@shinshu-u.ac.jp.
[Ti] Title:Early diagnosis of early-onset sarcoidosis: a case report with functional analysis and review of the literature.
[So] Source:Clin Rheumatol;36(5):1189-1196, 2017 May.
[Is] ISSN:1434-9949
[Cp] Country of publication:Germany
[La] Language:eng
[Ab] Abstract:This study examined the pathogenesis of early-onset sarcoidosis (EOS) in a patient with a rare NOD2 mutation and surveyed the literature to identify the hallmark features for early diagnosis. An infant girl suffering from prolonged fever and skin rash of multiple pinkish papules and subsequent erythema nodosum was referred to our institution. Skin biopsy and DNA sequencing were performed along with cytokine profiling of the patient's serum and stimulated mononuclear cells. NF-κB activation was analyzed using transfected cells. Multiple non-caseating granuloma inclusions were recognized in biopsy specimens obtained from the patient's rash. DNA sequencing revealed a very rare heterozygous Met513Thr (M513T) mutation in NOD2. Mononuclear cells produced a low amount of IL-1ß upon stimulation as compared with normal control cells. Mutated NOD2 transfection enhanced NF-κB activation. We suspected that the M513T mutation in NOD2 decreased IL-1ß production and enhanced NF-κB activation, which was likely responsible for the patient's granuloma involvement. A comprehensive review of the literature on 30 cases of sporadic type of EOS revealed that all patients had cutaneous manifestations, with all but one displaying granulation. A majority of EOS patients have R334W/Q. But about half of sporadic EOS had NOD2 mutations other than R334W/Q, as in the present case. Accordingly, skin rash with granuloma formation and specific NOD2 mutations may represent early diagnostic hallmarks of EOS in infants with persistent inflammation.
[Pt] Publication type:JOURNAL ARTICLE; REVIEW
[Em] Entry month:1701
[Cu] Class update date: 171013
[Lr] Last revision date:171013
[St] Status:In-Process
[do] DOI:10.1007/s10067-017-3544-6

  10 / 3649 MEDLINE  
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[PMID]: 28901560
[Au] Autor:Tetzlaff MT; Jazaeri AA; Torres-Cabala CA; Korivi BR; Landon GA; Nagarajan P; Choksi A; Chen L; Uemura M; Aung PP; Diab A; Sharma P; Davies MA; Amaria R; Prieto VG; Curry JL
[Ad] Address:Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
[Ti] Title:Erythema nodosum-like panniculitis mimicking disease recurrence: A novel toxicity from immune checkpoint blockade therapy-Report of 2 patients.
[So] Source:J Cutan Pathol;, 2017 Sep 13.
[Is] ISSN:1600-0560
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:Immunotherapies targeting cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) and the programmed cell death 1 (PD-1) receptor and its ligand (PD-L1) have showed substantial therapeutic benefit in patients with clinically advanced solid malignancies. However, autoimmune toxicities are common and often significant adverse events with these agents. While rash and pruritus remain the most common cutaneous complications in treated patients, novel dermatologic toxicities related to immune checkpoint blockade continue to emerge as the number of patients exposed to immunotherapy increases. Here, we describe 2 patients treated with combination immunotherapy with ipilimumab and nivolumab who developed painful subcutaneous nodules. Although the findings were clinically concerning for disease recurrence, histopathologic examination of biopsies from the lesions revealed a subcutaneous mixed septal and lobular erythema nodosum-like panniculitis. Notably, neither patient received immunosuppressive therapy for these lesions, which subsequently remained stable, and both patients' cancer remained controlled. These cases show that the dermatologic toxicity profile of immune checkpoint blockade is diverse and continues to expand, and illustrates that recognition of such toxicities is critical to optimal patient management.
[Pt] Publication type:CASE REPORTS
[Em] Entry month:1709
[Cu] Class update date: 171013
[Lr] Last revision date:171013
[St] Status:Publisher
[do] DOI:10.1111/cup.13044


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