Abstract：
Erythema nodosum (EN), although relatively uncommon in the pediatric population, is the most frequent type of panniculitis in children. The present study aimed to report all the cases of children admitted to our tertiary pediatric hospital with the diagnosis of EN to evaluate the epidemiology, clinical manifestations, etiology, treatment, and the course of this disease in the pediatric age. This observational study retrospectively considered all children evaluated to the emergency room (ER) of Meyer Children\'s University Hospital, Florence, Italy, discharged with a diagnosis of EN over a 12-year period (from January 2009 to December 2021). Clinical and laboratory data were recorded using a standardized report form. Sixty-eight patients with EN were included. The etiologic diagnosis of EN was made in 38 children (55.9%): 29 (42.6%) had infection-related EN (in particular EBV and β-hemolytic streptococcus), 6 (8.8%) had Crohn\'s disease, 1 celiac disease, 1 Sjogren syndrome, and 1 Hodgkin lymphoma. In 30 patients (45%), no definitive diagnosis was reached, and they were defined as having idiopathic EN. Most of the laboratory tests were nonspecific. No statistical differences were found in the demographic and clinical data, and the main diagnostic laboratory parameters between patients with idiopathic EN versus those with secondary EN. Conclusion: Since EN can be isolated or the first manifestation of heterogeneous underlying pathologies, some of which can be severe and life-threatening, it is important to recognize it and carry out all the necessary etiological diagnostic investigations to understand its etiology and start the specific treatment. What is Known: • Erythema nodosum (EN) is the most frequent type of panniculitis in children. • It has been associated with a wide spectrum of disorders, such as different types of infection, malignancies, chronic inflammations, and drugs. What is New: • No statistical differences can be found in clinical features as well as laboratory data, between patients with idiopathic EN versus those with secondary EN. • A broad spectrum of investigations and a proper follow-up should be taken into account in order to prevent a delayed or missed secondary EN diagnosis.
摘要：
结节性红斑(EN),虽然在儿科人群中相对罕见，是儿童脂膜炎最常见的类型。本研究旨在报告我们三级儿科医院诊断为EN的所有儿童病例，以评估流行病学。临床表现，病因学,治疗,以及这种疾病在儿科年龄的病程。这项观察性研究回顾性地考虑了迈耶儿童医院急诊室（ER）评估的所有儿童，佛罗伦萨意大利,在12年期间（从2009年1月至2021年12月）诊断为EN出院。使用标准化报告表记录临床和实验室数据。纳入68例EN患者。38名儿童（55.9％）进行了EN的病因诊断：29名（42.6％）患有感染相关的EN（特别是EBV和β-溶血性链球菌），6人（8.8%）患有克罗恩病，1乳糜泻，1干燥综合征，和1个霍奇金淋巴瘤。在30名患者（45%）中，没有明确的诊断，他们被定义为患有特发性EN。大多数实验室检查是非特异性的。在人口统计学和临床数据中没有发现统计学差异，以及特发性EN患者与继发性EN患者之间的主要诊断实验室参数。结论：由于EN可以是孤立的或异质性潜在病理的第一表现，其中一些可能是严重的，危及生命，重要的是要认识到它，并进行所有必要的病因诊断调查，以了解其病因并开始特定的治疗。已知:•结节性红斑(EN)是儿童中最常见的脂膜炎类型。•它与广泛的疾病有关，例如不同类型的感染，恶性肿瘤,慢性炎症,和毒品。新增内容：•在临床特征和实验室数据中没有发现统计学差异，特发性EN患者与继发性EN患者之间的关系。•应考虑广泛的调查和适当的随访，以防止延迟或错过二次EN诊断。
