Service de rhumatologie, centre hospitalier Avignon, France
Service de dermatologie, centre hospitalier Avignon, France
Service de rhumatologie, centre hospitalier universitaire Toamasina, Madagascar
Service des laboratoires, centre hospitalier Avignon, France
The erythema nodosum is an acute septal hypodermitis due to a hypersensibility reaction that is “mediated” by the th1 cytokines patheway. The diagnosis may be easy but the etiological research can in certain circumstance represent a real problem. In opposition to the evolution of the idiopathic erythema nodosum who's generally benign, the secondary erythema nodosum follow the evolution of the causative disease. Malignant hemopathies figures in the rare aetiology of erythema nodosum. We report the case of an 84 years old woman hospitalised for anemia and an acute oligoarticular pain in the joint of inferior limb associated with an algic cutaneous eruption linked with an erythema nodosum that evolued for 2 weeks. The hemogram showed tricytopenia and circulating blasts. The myelogram confirmed the diagnosis of acute myeloblastic leukemia on prevalent myelodysplasia, and the skin biopsy confirmed the erythema nodosum. The clinical and para-clinical etiological assessment of the erythema nodosum was negative. The skin lesions did not regress despite the well-conducted rest and then the initiation of oral corticosteroid therapy (1 mg/kg), as did the hematological disease, the management of which was ultimately palliative given the poor general condition of the patient and the poor prognosis. To our knowledge, the association of erythema nodosum and leukemia is rare. This relationship remains poorly documented in the literature and its etiopathogenesis is poorly understood.