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Official Journal of the Italian Society of Dermatology and Sexually Transmitted Diseases
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 1,014
Online ISSN 1827-1820
Perez-Chua T., Miller D. D., Mahalingam M.
Dermatopathology Section, Department of Dermatology, Boston University School of Medicine, Boston, MA
We recently saw a 51 year-old female with a tender, erythematous nodule on the left elbow and histopathology consistent with Erythema nodosum (EN). A subsequent literature review of EN in non-lower extremity (LE) sites identified only three reports, with minimal histopathology, prompting the current study. We identified nine EN cases on non-LE sites over a 14-year period. Histopathology typical of EN observed included septal panniculitis, fibrosis and edema, a mixed septal inflammatory infiltrate with and spillover into adjacent lobules and Miescher’s radial granulomas. Atypical features observed included a mixed (septal and lobular) panniculitis, leukocytoclastic vasculitis, changes in septal small vessels (lymphocytic cuffing of septal venules, endothelial swelling), lipomembranous cystic change and asteroid bodies. To the best of our knowledge, this is the first study to detail the histopathologic findings of EN on non-LE sites. Similar to that noted in classical EN in the LE, findings from the current study indicate that EN in non-LE sites display typical as well as atypical features. Limitations include retrospective design and the unspecified duration of biopsied lesions relative to clinical presentation.