Erythema nodusm-Pediatric Oncall

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Gurmeet Singh, Reena Sood Department of Pediatrics and Department of Obstetrics and Gynaecology, Sh...

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Question
I have a problem in acasewitch was admitted in my hospital on\6\5\o6 with history of erythematous skin lesion over anterior aspect of both lower limb also there is of fever and pain on both knee jt my patient is 12 years old female over weight she had ahistory of URTI just 5 days befor she developed these rash the rash was painful sudden onset slight raised over skin there is h\o reccuent tonsilitis but no h\o cough \weight loss\night sweating \or moring stiffiness\ 0r Raynaud phenomena also there is no h\o truma \drugs\diarrhea\orweakness neigher convlsions\no family history any Rhematological disease on examination conscious not dyspnic\or tachypnic no paller or cynosis vital signs stable systemic examination was normal skin examination was normal investigations CBC was normal LFT RFT both were normal serology negative CRP andRhematoid factor both positive ASO and cold agglutination positive LE cell negative ANAB also negative Tuberculin test negative urine R\E and C\S both normal the working diagnosis was erythema nodusm we put the patient on Asprin antinflmatory dose the patient still no improvement sorry I forget to inform you that abdominal USS and C T both were normal thank you for hlep copperation your friend Dr najat .
Answer
How are the joint pains? Since the child has rash as well as joint pains with positive RA factor, one needs to observe her and see if she continues to have persistence of symptoms over a period of time and fits into the criteria of JRA. What is her ESR? She needs to be continued on NSAIDS. If she is not responding to aspirin, one may consider naproxen. Back to All Questions

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