結節性紅斑－－63病例之回溯性分析

Erythema Nodosum Retrospective Evaluation of 63 Cases

作者收集自1977年7月至1986年6月，10年間在榮民總醫院住院的63例結節性紅斑病人，作一回溯分析。好發年齡以20至39歲為最高（佔 57.1％），男女比率為1:5.3。其可能之致病因素包括結核菌素測驗陽性（18例，佔28.5％），鏈球菌感染（6例，佔9.52％），癩皮病（2例，佔3.17％），腸內菌（2例，佔3.17％），藥物（3例，佔4.75％），貝雪氏病(Behcet disease)（3例，佔4.75％）等；另有24例(38.O9％)在發病當時並無明顯的相關致病因素可循。表現症狀除病變本身的局部疼痛外，尚有發燒，關節痛、肌肉痛及倦怠等。發病時間並無明顯季節性差異。三分之一的病人以反覆發作方式為其表現型態。29例病人(46.0％)、病情為急性發作，其皮膚變化皆在三個月內緩解或消失；另外13例(20.7％)則為慢性，病變持續超過三個月以上。大多數病人因致病原 因不清楚而未予特定治療。僅一例經氣管鏡檢查證實為氣管內結核病者，予以抗結核藥物後，皮膚症狀在一個月內消失。二例癩皮病病人經抗癩皮病藥物治療後，皮膚症狀未再復發。

In a retrospective study to evaluate the clinical pictures of erythema nodosum (EN), 63 inpatient records in Veterans General Hospital from July to June 1986 were studied. It appeared more frequently between age of 20 to 39 years (57.1% of all patients) and it was more predominant in female than in male with rate of 5.3 to 1. The underlying diseases or possible etiological factors included tuberculosis (28.5%), streptococcus (9.5%), leprosy (3.17%), Enterobacte riacea (3.17%), drugs (4.75%) and Behcet's disease (4.75%). Twenty- four patients could not be found to have any significant causing factors. The clinical presentations included indurated & tender erythematous nodules, fever, arthralgia, myalgia, and general malaise. There was no seasonal variation. The lesions were recurrent in one third of the patients. All of the chronic cases (20.7%) retained their skin lesions for more than 3 months with or without treatment. Most of the patients did not undergo specific medication due to obscurity of the underlying Causes EN was eventually recovery in one female patient after she was confirmed to have endobronchial tuberculosis and received anti- tuberculosis management. There were two patients with erythema nodosum leprae who underwent sulfone treatment and got subsidence of the skin eruptions.