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Investigations

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Investigation should be directed at finding an underlying cause:

  • careful history - especially attention to drugs
  • complete blood count with differential – ESR and CRP
  • evaluation for streptoccocal infection (e.g., throat culture for group A streptococci, antistreptolysin-O titer, and polymerase chain reaction assay)
  • consider possible sarcoidosis or tuberculosis
    • chest xray, purified protein derivative test
  • viral titres may be indicated:
    • viral causes of erythema nodosum include:
      • herpes simplex virus, Epstein-Barr virus, hepatitis B and C viruses, human immunodeficiency virus
  • stool culture may be indicated in some patients
    • stool culture and evaluation for ova and parasites in patients with diarrhea or gastrointestinal symptoms
    • consider evaluation for inflammatory bowel disease
  • excisional biopsy – if clinical diagnosis is in doubt (1)
    • key histologic findings are septal panniculitis, actinic (Miescher's) radial granulomas, lymphocytic infiltrate with neutrophils, absence of vasculitis, and no organisms

 

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