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Autumn/Winter 2022, Vol. 30 No. 1

Hong Kong J. Dermatol. Venereol. (2022) 30, 19-22


Case Report

A window for effective diagnosis: Erythema nodosum in a girl with newly diagnosed ulcerative colitis

通往有效診斷的那扇窗:一名初診斷潰瘍性結腸炎的女孩的結節性紅斑

KC Cheng 鄭嘉俊, WS Lau 劉詠詩, SM Wong 黃思敏

Abstract

An eight-year-old girl presented with tender erythematous nodules over bilateral shins and right forearm for two weeks. She had a recent admission for fever and loose stool with a presumed diagnosis of gastroenteritis. Erythema nodosum associated with infective gastroenteritis was initially suspected. But further history revealed a two-month history of recurrent fever and loose stool with a history of short stature. Investigations showed iron-deficiency anaemia, positive fecal occult blood and negative stool microbiological workup lead to the suspicion of an alternative diagnosis. Skin biopsy showed panniculitis with septal and lobular involvement. Subsequent colonoscopy confirmed the diagnosis of underlying ulcerative colitis.

一名 8 歲女孩,過去兩週在雙側小腿和右前臂出現疼痛的紅色結節。此前她曾因發燒和稀便而入院,當次被推測診斷為腸胃炎。這次開初懷疑是與感染性胃腸炎相關的結節性紅斑,但經病史探索後,發現她有兩個月的反復發熱和稀便史,並身材矮小的病史。檢查顯示有缺鐵性貧血及大便潛血陽性, 大便微生物檢查則呈陰性,以上種種不期然令人懷疑有其他鑒別診斷的可能。皮膚活檢顯示脂膜炎伴有隔膜和小葉受累。隨後的結腸鏡檢查診斷出潛在的潰瘍性結腸炎。

Keywords: Erythema nodosum, panniculitis, ulcerative colitis

關鍵詞: 結節性紅斑、脂膜炎、潰瘍性結腸炎