Erythema nodosum as a presentation of a rare syndrome: regarding a clinical case
DOI:
https://doi.org/10.32385/rpmgf.v40i4.13853Keywords:
Erythema nodosum, Sarcoidosis, Telemedicine, Case reportAbstract
Introduction: Lofgren’s syndrome is a benign and self-limiting form of sarcoidosis that progresses with the triad: low fever, joint pain, and erythema nodosum. The diagnosis is based on the clinical presentation and the treatment is symptomatic. The case presented addresses the diagnosis and treatment of this syndrome, as well as the importance of the family doctor in its management and evolution.
Case description: A female patient, 33 years old, with a family history of sarcoidosis, went to her Family Health Unit with polyarthralgia and skin lesions, having been initially medicated with dexamethasone with clinical improvement. Through telephone follow-up with her family doctor, after weaning off corticosteroid therapy, the patient suffered a relapse and worsening of symptoms, being observed and referred to the emergency service of the hospital in the area of residence, and being hospitalized for treatment and etiological study. The diagnosis of Lofgren’s syndrome was established during hospitalization, and the patient was discharged clinically, with corticosteroid therapy instituted, which should be maintained for four to six months.
Comment: This case highlights the role of the family doctor in the management, diagnosis, and follow-up of a rare, benign syndrome, which we must be aware of. It also shows the advantages and importance of telemedicine as a support tool in primary health care.
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References
Visser H, Vos K, Zanelli E, Verduyn W, Schreuder GM, Speyer I, et al. Sarcoid arthritis: clinical characteristics, diagnostic aspects, and risk factors. Ann Rheum Dis. 2002;61(6):499-504.
Ponhold W. Das Löfgren-Syndrom: die akute form der sarkoidose [The Löfgren syndrome: acute sarcoidosis]. Rontgenblatter. 1977;30(6):325-7. German.
James DG, Thomson AD, Willcox A. Erythema nodosum as a manifestation of sarcoidosis. Lancet. 1956;271(6936):218-21.
Zisman DA, Shorr AF, Lynch JP 3rd. Sarcoidosis involving the musculoskeletal system. Semin Respir Crit Care Med. 2002;23(6):555-70.
Flores R, Caridade S. Löfgren syndrome: clinical presentation, clinical course, and literature review. Cureus. 2023;15(1):e33651.
Mañá J, Gómez-Vaquero C, Montero A, Salazar A, Marcoval J, Valverde J, et al. Löfgren’s syndrome revisited: a study of 186 patients. Am J Med. 1999;107(3):240-5.
Gajarawala SN, Pelkowski JN. Telehealth benefits and barriers. J Nurse Pract. 2021;17(2):218-21.
Mahtta D, Daher M, Lee MT, Sayani S, Shishehbor M, Virani SS. Promise and perils of telehealth in the current era. Curr Cardiol Rep. 2021;23(9):115.
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