摘要
結節性紅斑(erythema nodosum)的臨床表現常是急性、疼痛性、邊緣不明顯、非潰瘍性之紅色丘疹，一般常見於雙側下肢伸展側，好發於年輕女性。結節性紅斑是一種抗原刺激造成的炎性反應，屬於一種非特異性延遲性過度敏感反應(nonspecific delayed-type hypersensitivity reaction)，也有人認為與免疫複合體的形成及補體活化有關。結節性紅斑常併發於多種潛在性的疾病，如藥物、感染症、系統性發炎疾病、及惡性腫瘤等等。大部份結節性紅斑的病例可由典型之臨床表現直接作診斷，但對於一些難以區分的壓痛性紅色結節病灶，則必須考應進一步皮膚切片檢查以確定診斷。典型的病理表現為中隔性脂層炎(panniculitis)，可見到多形性白血球、淋巴球、甚至多核巨細胞於皮下脂肪之纖維中隔組織中浸潤。 在此，我們報告一位年輕女性，結節性紅斑分佈不是常見局限於雙側脛前區域，而是擴散至雙側大腿、上臂及肩膀。經深層皮膚切片確定診斷為結節性紅斑，但組織學上並非以常見典型的中隔性脂層炎方式來表現。經系列檢查發現可能是由鏈球菌感染後，或是藥物所引起的非典型表現結節性紅斑。 治療結節性紅斑，一定要先追查有無潛在的疾病並給予適當的治療，絕大部份病例會自行痊癒。臥床休息、冷敷或熱敷、給予抗甲狀腺藥物碘化鉀、阿斯匹靈或非類固醇抗發炎藥物皆有不錯的效果，少有併發症。
並列摘要
The clinical presentation of erythema nodosum (EN) is an acute, ill-defined, nonulcerative, erythematous, and painful eruption that is usually limited to the extensor aspects of the lower legs. The majority of patients are female. Erythema nodosum probably is a delayed hypersensitivity reaction to a variety of antigens. The process may be associated with a wide variety of conditions, such as medications, infections, systemic inflammatory diseases, malignancies, and so on. Diagnosis is usually based on a compatible clinical presentation. With atypical feature patient, deep skin biopsy is necessary for confirmation. The typical pathology presentation is septal panniculitis, that neutrophils, lymphocytes, and even multinucleated giant cells were infiltrated in periseptal areas of the fat lobules. Herein, we presented a young female who suffered from multiple red and tender skin nodules located on her thighs, arms, and shoulders but not typically on anterior legs. Skin biopsy was performed and EN was diagnosed but not typically septal panniculitis. Treatment of EN should be directed to the underlying associated condition, if identified. In most patients, EN is a self-limited disease and requires only symptomatic relief using nonsteroidal antiinflammatory drugs, potassium iodide, cool wet compresses, elevation, and bed rest.