Exploring the combination of SSKI and topical heparin in a case of erythema nodosum migrans

Dermatol Ther. 2018 Jul;31(4):e12610. doi: 10.1111/dth.12610. Epub 2018 Apr 11.

Abstract

Erythema nodosum migrans (subacute nodular migratory panniculitis) is an uncommon type of panniculitis characterized by migrating subcutaneous nodules or plaque on the lower extremity. There are a very few cases of Erythema nodosum migrans reported and thus its appropriate treatment modality is not defined. We describe a case of a 30-year-old male with idiopathic erythema nodosum migrans which was manifest centrifugally spreading, slightly morpheaform erythematous plaque on the lower left leg. The patient was diagnosed initially and treated as a case of furunculosis with poor clinical response. The skin biopsy showed features consistent with subacute nodular panniculitis. Saturated Solution of Potassium Iodide along with topical Heparin successfully treated the patient, when the conventional treatment modalities failed. In a morpheaform centrifugally expanded plaque, erythema nodosum migrans should be kept in mind in the differential diagnosis, especially in the lower extremities in cases of unknown etiology.

Keywords: erythema nodosum migrans; panniculitis.

Publication types

  • Case Reports

MeSH terms

  • Administration, Cutaneous
  • Administration, Oral
  • Adult
  • Biopsy
  • Drug Therapy, Combination
  • Erythema Nodosum / diagnosis
  • Erythema Nodosum / drug therapy*
  • Heparin / administration & dosage*
  • Humans
  • Male
  • Panniculitis / diagnosis
  • Panniculitis / drug therapy*
  • Potassium Iodide / administration & dosage*
  • Remission Induction
  • Treatment Outcome

Substances

  • Potassium Iodide
  • Heparin

Supplementary concepts

  • Erythema nodosum, idiopathic