Erythema nodosum

Abstract

Context: The role of the family doctor, often the first contact that patients have with the health system, is to approach initially several pathologies and to articulate them with other health care levels. Erythema nodosum (EN) is a multiple etiology clinical syndrome. The therapy requires a research on the most frequent causes and their specific treatment. It is the most frequent panniculitis version and, therefore, both its recognition and study by the family doctor are very important. Case description: Nineteen years old woman, unemployed, with Graffar V and family Apgar 9. The woman visited her family doctor due to the appearance of painful, vinosa and nodular lesions in inferior limbs associated with artralgies with 5 days of evolution. The family doctor identified it as EN, initiated the investigation and medicated the patient with an anti-inflammatory. Patient symptoms persisted and worsened and, therefore, the patient went to the hospital emergency services, where she took a torax x-ray and was medicated with antibiotherapy. Since the clinical condition kept persisting, the family doctor came once more at play, recommending her to go to the hospital, where she was interned. After the analytical and imagiological studies, sarcoidosis was diagnosed, having as first clinical manifestation, the erythema nodosum. Discussion: This clinical case aims to show the articulation between primary health care and secondary health care, allowing a broad study of Erythema nodosum. It gives the opportunity to review the medical approach, from the initial clinical investigation to the diagnosis exams that are important for EN etiologic research.