Background Erythema nodosum (EN) is a type of septal panniculitis with multiple underlying etiological trigger factors. Combination of EN with involvement of ankle joints, fever and intra-thoracic lymphatic nodes (ITLN) is known as the Lőfgren syndrome. This syndrome is associated with acute clinical course of sarcoidosis, which usually does not require a morphological confirmation.
Objectives To analyze specific clinical features of EN in sarcoidosis patients.
Methods 125 EN patients (M-21,F-104), aged 18 - 69 years associated with sarcoidosis were examined. All patients were subjected to standard diagnostic clinical examination and lab procedures, including chest computed tomography (CT).
Results Mean age of patients was 42±12 years. Disease duration up to 1 month was documented in 35% patients, 1- 3 months – in 41%, >3 months – in 20%. Range of complaints included cough – in 24% patients, and fatigue – in 10%. Dyspnea, sweating, myalgia, and sore throat were found in 5% of patients each, respectively. Skin lesions typically occurred on the lower leg (96%), but also on the thighs (35%), the upper limbs (24%), and on the trunk (3%). Average number of nodules was 15±13. More than 10 nodules in number were documented in 64% of cases. Dense aggregation of nodules was found in 46% patients. The VAS score was 45±28 mm. Acute EN course was documented in 20% of cases, subacute - in 62%, and chronic – in 18% of patients. Distribution of joints involved looks as follows: ankles – 92%, shoulder – 11%, small joints in the hand and feet– 3%. CT findings included enlarged ITLN in 65% of cases, ground glass opacity (GGO) pulmonary lesions- in 35%. GGO pulmonary lesions predominated in male patients (30%), (p=0,004 R=0,25), demonstrating nodule-aggregation pattern in the majority of cases (p=0,0009 R=0,29). In patients with isolated ITLN involvement, cough (p=0,0048 R=0,25), and subacute course (p=0,016 R=0,22) were the special clinical features of the disease.
Conclusions combination of ankle joints involvement, fever, and EN necessitates thoracic CT, as in 1/3 of such patients lungs would inevitably be involved. Male gender and EN aggregation pattern are most likely indicative of the emergence of GGO-symptom.
Disclosure of Interest None declared