DermAtlas: Online Dermatology Image Library dermatology image,erythema nodosum,acne vulgaris,acne fulminans,Crohn disease,inflammatory bowel disease,neutrophilic dermatosis

© 2001-2010, DermAtlas	*Image Name:*	erythema_nodosum_1_091201	*File Type:*	jpg
	*Diagnosis:*	ERYTHEMA NODOSUM	*Category:*	cutaneous sign of systemic disease / fat disorder / hypersensitivity
	*Body Site:*	leg	*Age:*	56 years
	*Contributor:*	Greg Hosler, MD, PhD
	*Description:*	This punch biopsy of skin shows an infiltrate in the dermis and superficial subcutis. There is thickening of the fibrous septae.
	*Comments:*	This woman presented with erythematous and painful nodules on her shins, bilaterally. Erythema nodosum (EN) was suspected clinically and confirmed histologically. EN is a septal panniculitis, and when thickened septae are present without lobular involvement, the diagnosis is straightforward. Early lesions may be more suppurative and a mixed septal/lobular picture may also be present. Another useful finding is the presence of Miescher radial granulomas, as in this case. The etiology of EN is unknown, but due to its association with many inflammatory and infectious conditions, a hypersensitivity reaction is favored. Treatment of the underlying condition often results in resolution of the cutaneous lesions.
	*Related Images:*	erythema_nodosum_2_091201

© 2001-2010, DermAtlas	*Image Name:*	erythema_nodosum_2_091201	*File Type:*	jpg
	*Diagnosis:*	ERYTHEMA NODOSUM	*Category:*	cutaneous sign of systemic disease / fat disorder / hypersensitivity
	*Body Site:*	leg	*Age:*	56 years
	*Contributor:*	Greg Hosler, MD, PhD
	*Description:*	Within the thickened septae, there are collections of histiocytes. Several Miescher radial granulomas are present, with histiocytes aggregating aroung slit-like spaces. There is background fibrosis. A significant lobular infiltrate is not appreciated.
	*Comments:*	This woman presented with erythematous and painful nodules on her shins, bilaterally. Erythema nodosum (EN) was suspected clinically and confirmed histologically. EN is a septal panniculitis, and when thickened septae are present without lobular involvement, the diagnosis is straightforward. Early lesions may be more suppurative and a mixed septal/lobular picture may also be present. Another useful finding is the presence of Miescher radial granulomas, as in this case. The etiology of EN is unknown, but due to its association with many inflammatory and infectious conditions, a hypersensitivity reaction is favored. Treatment of the underlying condition often results in resolution of the cutaneous lesions.
	*Related Images:*	erythema_nodosum_1_091201

© 2001-2010, DermAtlas	*Image Name:*	erythema_nodosum_3_080809	*File Type:*	jpg
	*Diagnosis:*	ERYTHEMA NODOSUM	*Category:*	fat disorder / reactive erythema
	*Body Site:*	shin / leg	*Age:*	20 months
	*Contributor:*	Bernard Cohen, MD
	*Description:*	tender symmetric red-purple deep seated 2-3 cm nodules
	*Comments:*	This heatlhy toddler developed left inguinal adenitis which was incised and drained and treated with parenteral clindamycin for 3 days and oral clindamycin for an additional 5 days. At the end of her course of oral antibiotics the adenitis had resolved, but she developed subcutaneous mildly tender pretibial nodules. The eruption resolved 3 days after discontinuation of the oral antibiotic and left a faint purple discoloration.
	*Related Images:*	All related Images erythema_nodosum_2_080809 erythema_nodosum_1_080809

© 2001-2010, DermAtlas	*Image Name:*	erythema_nodosum_1_080809	*File Type:*	jpg
	*Diagnosis:*	ERYTHEMA NODOSUM	*Category:*	fat disorder / reactive erythema
	*Body Site:*	shin / leg	*Age:*	20 months
	*Contributor:*	Bernard Cohen, MD
	*Description:*	tender symmetric red-purple deep seated 2-3 cm nodules
	*Comments:*	This heatlhy toddler developed left inguinal adenitis which was incised and drained and treated with parenteral clindamycin for 3 days and oral clindamycin for an additional 5 days. At the end of her course of oral antibiotics the adenitis had resolved, but she developed subcutaneous mildly tender pretibial nodules. The eruption resolved 3 days after discontinuation of the oral antibiotic and left a faint purple discoloration.
	*Related Images:*	All related Images erythema_nodosum_2_080809 erythema_nodosum_3_080809

© 2001-2010, DermAtlas	*Image Name:*	erythema_nodosum_2_080809	*File Type:*	jpg
	*Diagnosis:*	ERYTHEMA NODOSUM	*Category:*	fat disorder / reactive erythema
	*Body Site:*	shin / leg	*Age:*	20 months
	*Contributor:*	Bernard Cohen, MD
	*Description:*	tender symmetric red-purple deep seated 2-3 cm nodules
	*Comments:*	This heatlhy toddler developed left inguinal adenitis which was incised and drained and treated with parenteral clindamycin for 3 days and oral clindamycin for an additional 5 days. At the end of her course of oral antibiotics the adenitis had resolved, but she developed subcutaneous mildly tender pretibial nodules. The eruption resolved 3 days after discontinuation of the oral antibiotic and left a faint purple discoloration.
	*Related Images:*	All related Images erythema_nodosum_1_080809 erythema_nodosum_3_080809

© 2001-2010, DermAtlas	*Image Name:*	acne_fulminans_6_070318	*File Type:*	jpg
	*Diagnosis:*	ACNE VULGARIS / ACNE FULMINANS / ERYTHEMA NODOSUM	*Category:*	reactive erythema
	*Body Site:*	leg	*Age:*	18 years
	*Contributor:*	Bernard Cohen, MD
	*Description:*	symmetric tender red deep seated indurated plaques
	*Comments:*	This healthy adolescent with moderate acne suddenly developed tender eroded papules and nodules in a necklace (seborrheic) pattern on his chest, shoulders, upper arms, and back. The acute flare of of inflammatory acne was associated with fever and erythema nodosum. He settled down quickly on oral prednisone followed by the initiation of oral 13-cis retinoid acid.
	*Related Images:*	All related Images acne_fulminans_7_070318 acne_fulminans_5_070318 acne_fulminans_4_070318 acne_fulminans_3_070318 acne_fulminans_2_070318 acne_fulminans_1_070318

© 2001-2010, DermAtlas	*Image Name:*	Erythema_nodosum_1_050525	*File Type:*	jpg
	*Diagnosis:*	ERYTHEMA NODOSUM	*Category:*	lumps & bumps (plaques, nodules, tumors)
	*Body Site:*	leg	*Age:*	36 years
	*Contributor:*	Nikolaos Sferopoulos, MD
	*Description:*	tender firm erythematous subcutaneous nodules
	*Comments:*	A 36-year- old woman developed tender, violaceous, nonulcerative, subcutaneous nodules on her right shin 2 weeks ago. The eruption was accompanied by low grade fever and general malaise for the first few days. She was treated with nonsteroidal antiinflammatory drugs for a painful chondromalacia of the patella about a month ago . She had also received 4 courses of oral antibiotics during the last 4 months for tonsillitis.

© 2001-2010, DermAtlas	*Image Name:*	cutaneous_crohns_disease_4_050505	*File Type:*	jpg
	*Diagnosis:*	CROHN DISEASE / INFLAMMATORY BOWEL DISEASE / NEUTROPHILIC DERMATOSIS / ERYTHEMA NODOSUM	*Category:*	reactive erythema
	*Body Site:*	leg	*Age:*	16 years
	*Contributor:*	Bernard Cohen, MD
	*Description:*	confluent erythematous plaques, nodules, pustules, and crusts
	*Comments:*	This adolescent, who was experiencing a severe flare of Crohn disease, developed tender red papules, plaques, pustules, and plaques on his upper arms, thighs, shins, and face. Although he was initially diagnosed with a steroid induced eruption, hight dose steroids cleared his skin lesions.
	*Related Images:*	All related Images cutaneous_crohns_disease_5_050505 cutaneous_crohns_disease_3_050505 cutaneous_crohns_disease_2_050505 cutaneous_crohns_disease_1_050505

© 2001-2010, DermAtlas	*Image Name:*	cutaneous_crohns_disease_5_050505	*File Type:*	jpg
	*Diagnosis:*	CROHN DISEASE / INFLAMMATORY BOWEL DISEASE / NEUTROPHILIC DERMATOSIS / ERYTHEMA NODOSUM	*Category:*	reactive erythema
	*Body Site:*	leg	*Age:*	16 years
	*Contributor:*	Bernard Cohen, MD
	*Description:*	pustules and deep seated red plaques
	*Comments:*	This adolescent, who was experiencing a severe flare of Crohn disease, developed tender red papules, plaques, pustules, and plaques on his upper arms, thighs, shins, and face. Although he was initially diagnosed with a steroid induced eruption, hight dose steroids cleared his skin lesions.
	*Related Images:*	All related Images cutaneous_crohns_disease_4_050505 cutaneous_crohns_disease_3_050505 cutaneous_crohns_disease_2_050505 cutaneous_crohns_disease_1_050505

© 2001-2010, DermAtlas	*Image Name:*	erythema_nodosum_1_041024	*File Type:*	jpg
	*Diagnosis:*	ERYTHEMA NODOSUM	*Category:*	lumps & bumps (plaques, nodules, tumors) / cutaneous sign of systemic disease
	*Body Site:*	leg	*Age:*	30 years
	*Contributor:*	Yahia Albaili, DO
	*Description:*	symmetric deep seated tender red nodules
	*Comments:*	This 30-year-old woman developed erythema nodosum on the legs associated with fever and arthralgias.