Aetiology
A wide range of antigenic stimuli are implicated: (1)
Common causes include:
- idiopathic - up to 55%
- sarcoidosis - 30 to 40% of cases
- infectious causes:
- streptococcal/viral throat infections - most common
- chlamydia - relatively common
- tuberculosis - relatively common
- mycoplasma
- yersinosis - more common in non-UK European countries
- rarely, histoplasmosis, leprosy, psittacosis, cat-scratch disease, lymphogranuloma venereum
- inflammatory causes:
- inflammatory bowel disease:
- Crohn's
- ulcerative colitis
- rarely, Behcet's disease
- inflammatory bowel disease:
- drugs are a common cause:
- sulphonamides
- oral contraceptive pill
- malignancy:
- lymphoma, leukaemia
- post-radiation therapy
- pregnancy
Rare cause include:
- Infections
- Viral – herpes simplex virus, Epstein-Barr virus, hepatitis B and C viruses, HIV
- Bacterial - Campylobacter spp., rickettsiae, Salmonella spp., psittacosis
- Parasitic - amoebiasis, giardiasis
- malignancy:
- lymphoma, leukaemia
- post-radiation therapy
- often no cause is found
Reference:
- Pérez-Garza DM, Chavez-Alvarez S, Ocampo-Candiani J, et al. Erythema nodosum: a practical approach and diagnostic algorithm. Am J Clin Dermatol. 2021 May;22(3):367-78.
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