griseofulvin and Erythema-Nodosum

A 9-year-old girl, presented with a 4-week history of an inflammatory suppurative plaque, 8 cm in diameter, localised in the occipital area of the scalp. Mycological direct examination showed ectoendothrix invasion of the hair and Trichophyton mentagrophytes was isolated. Oral therapy with griseofulvin 25 mg kg(-1)  day(-1) was prescribed, but after 2 weeks of treatment appeared multiple erythematous subcutaneous nodules localised in the legs. Erythema nodosum (EN) was confirmed by histological examination of a nodule and then we combined therapy with 1 mg Kg(-1)  day(-1) of prednisone. At the remission of the panniculitis, which occurred in about 10 days, the steroid therapy was suspended, while the orally administered griseofulvin continued for 6 weeks until full recovery. EN is the most frequent clinical form of acute nodular panniculitis and it is considered an epiphenomenon relative to various infectious and non-infectious stimuli. The association of EN with dermatophytosis of the scalp is infrequent, with only 15 cases reported in the Literature.

Topics: Antifungal Agents; Child; Drug Therapy, Combination; Erythema Nodosum; Female; Griseofulvin; Hair; Humans; Leg; Neutrophil Infiltration; Prednisone; Scalp; Subcutaneous Fat; Tinea Capitis; Trichophyton

Topics: Arthritis; Arthritis, Rheumatoid; Erythema Nodosum; Femur Head; Gout; Griseofulvin; Hip; Humans; Joint Diseases; Knee; Osteoarthritis; Osteoporosis; Purpura; Rheumatic Diseases; Rheumatic Fever; Rheumatology; Sciatica; Spinal Diseases

Topics: Antifungal Agents; Child, Preschool; Dermatomycoses; Erythema Nodosum; Female; Griseofulvin; Humans; Occipital Bone; Trichophyton

We describe the case of a 45-year-old man with atopy who developed marked inflammatory lesions on the bearded area of the face caused by Tricophyton rubrum, an anthropophilic fungus not frequently correlated with kerion of the face. After starting therapy with griseofulvin, he developed typical lesions of erythema nodosum on both legs. We discuss how these lesions could be correlated with the kerion of the face.

Topics: Antifungal Agents; Erythema Nodosum; Facial Dermatoses; Griseofulvin; Humans; Male; Middle Aged; Tinea

Three children had pustular patches develop over the occipital areas of the scalp. Colonies of Trichophyton mentagrophytes grew on cultures with Sabouraud's dextrose agar with antibiotics. After a week of topical treatment with 1:10,000 potassium permanganate solution and oral treatment with griseofulvin, typical nodules of erythema nodosum appeared over the shins, ranging in diameter from 1 to 4 cm. Nodules on the legs resolved spontaneously within 12 days in the three children. Erythema nodosum occurring in patients with kerion may be interpreted as individual allergic hypersensitivity reactions as a result of the immune host response to allergenic products from the primary site of infection. This possibly may cause immune complexes that precipitate erythema nodosum.

Topics: Child; Erythema Nodosum; Female; Griseofulvin; Humans; Male; Potassium Permanganate; Scalp Dermatoses; Tinea Capitis; Trichophytin