结节性红斑病因诊断的专家共识(2025版)

doi:10.19982/j.issn.1000-6621.20250195

中国防痨杂志 ›› 2025, Vol. 47 ›› Issue (9): 1126-1134.doi: 10.19982/j.issn.1000-6621.20250195

结节性红斑病因诊断的专家共识(2025版)

国家感染性疾病临床医学研究中心, 北京大学深圳医院, 深圳市炎症与免疫性疾病重点实验室, 深圳市第三人民医院, 结节性红斑病因诊断的专家共识小组

收稿日期:2025-05-13 出版日期:2025-09-10 发布日期:2025-08-27
基金资助:
国家自然科学基金(82070016);国家自然科学基金(81974253);国家自然科学基金(81901641);广东省感染性疾病(结核病)临床医学研究中心(2020B1111170014);深圳市结核病临床医学研究中心(20210617141509001);深圳市科技创新委员会重点基础研究项目(JCYJ20210324131813036);深圳市“医疗卫生三名工程”项目(SZSM202311030);深圳市“医疗卫生三名工程”项目(SZZYSM202311009);深圳市炎症与免疫性疾病重点实验室(ZDSYS20200811143756018);深圳市医学研究专项资金(C2301008);深圳市科技计划项目(KCXFZ20211020163545004);深圳市科技计划项目(RCJC20221008092726022)

Expert consensus on the etiology and diagnosis of erythema nodosum (2025 version)

Received:2025-05-13 Online:2025-09-10 Published:2025-08-27
Supported by:
National Natural Science Foundation of China(82070016);National Natural Science Foundation of China(81974253);National Natural Science Foundation of China(81901641);Guangdong Province Clinical Research Center for Infectious Diseases(2020B1111170014);Shenzhen Research Center for Infectious Diseases(20210617141509001);Key Basic Research Project of Shenzhen Science and Technology Innovation Commission(JCYJ20210324131813036);Sanming Project of Medicine in Shenzhen(SZSM202311030);Sanming Project of Medicine in Shenzhen(SZZYSM202311009);Shenzhen Key Laboratory of Immunity and Inflammatory Diseases(ZDSYS20200811143756018);Special Fund for Medical Research in Shenzhen(C2301008);Shenzhen Science and Technology Program(KCXFZ20211020163545004);Shenzhen Science and Technology Program(RCJC20221008092726022)

摘要/Abstract

摘要：

结节性红斑的病因复杂,可能与感染、自身免疫疾病、肿瘤、药物及特发性等多个因素相关。如何明确结节性红斑的病因及其诊断策略是一个亟待解决的临床问题。由国家感染性疾病临床医学研究中心、深圳市第三人民医院联合北京大学深圳医院、深圳市炎症与免疫性疾病重点实验室,共同制定了我国第一部关于结节性红斑病因诊断的专家共识。本共识详细阐明结节性红斑的病因分类及发生机制,并对结节性红斑病因诊断流程、病理表现及鉴别诊断,给出了基于循证的推荐,旨在规范结节性红斑的诊断流程,提高结节性红斑的诊断和治疗水平,从而改善患者的生活质量和预后。

关键词: 红斑, 结节性, 感染, 风湿性疾病, 诊断, 总结性报告(主题)

Abstract:

Erythema nodosum is a complex disorder with etiologies associated with infections, autoimmune diseases, tumors, medications, and idiopathic factors. Clarifying the causes of erythema nodosum and its diagnostic strategies remains a pressing clinical challenge. This is the first expert consensus in China focused on the etiology and diagnosis strategy of erythema nodosum. It is jointly developed by the National Clinical Research Center for Infectious Diseases, the Third People’s Hospital of Shenzhen, Peking University Shenzhen Hospital, and the Shenzhen Key Laboratory of Inflammation and Immunity. This consensus document comprehensively examines the etiological classification and pathogenesis of erythema nodosum. Furthermore, it outlines the diagnostic approach for its diverse etiologies, details associated pathological findings, and discusses differential diagnoses, providing evidence-based recommendations throughout. It aims to standardize the diagnostic process for erythema nodosum and improve diagnostic and therapeutic practices, ultimately improving patient outcomes and prognosis.

Key words: Erythema nodosum, Infection, Rheumatic diseases, Diagnosis, Consensus development conferences as topic

中图分类号:

R758.61

国家感染性疾病临床医学研究中心, 北京大学深圳医院, 深圳市炎症与免疫性疾病重点实验室, 深圳市第三人民医院, 结节性红斑病因诊断的专家共识小组. 结节性红斑病因诊断的专家共识(2025版)[J]. 中国防痨杂志, 2025, 47(9): 1126-1134. doi: 10.19982/j.issn.1000-6621.20250195

National Clinical Research Center for Infectious Diseases , Peking University Shenzhen Hospital , Shenzhen Key Laboratory of Immunity and Inflammatory Diseases , The Third People’s Hospital of Shenzhen , Expert Consensus Group on the Etiology and Diagnosis of Erythema Nodosum . Expert consensus on the etiology and diagnosis of erythema nodosum (2025 version)[J]. Chinese Journal of Antituberculosis, 2025, 47(9): 1126-1134. doi: 10.19982/j.issn.1000-6621.20250195

图/表 6

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证据级别	具体描述	研究类型	表达字母
高质量证据	非常确信真实的效应值接近效应估计,未来研究几乎不可能改变现有评价结果的可信度	随机对照试验;质量升高二级的观察性研究	A
中质量证据	对效应估计值有中等程度的信心:真实值有可能接近估计值,但仍存在二者大小相同的可能性;未来研究可能对现有评估有重要影响,可能改变评价结果的可信度	质量降低一级的随机对照试验;质量升高一级的观察性研究	B
低质量证据	对效应估计值的确信程度有限:真实值可能与估计值大不相同;未来研究很有可能对现有评估有重要影响,改变评估结果可信度的可能性较大	质量降低二级的随机对照试验;观察性研究	C
极低质量证据	对效应估计值几乎没有信心:真实值很可能与估计值大不相同;任何评估都很不确定	质量降低三级的随机对照试验;质量降低一级的观察性研究;系列病例观察;个案报道	D

推荐强度	具体描述	表达数字
支持使用某项干预措施的强推荐	评价者确信干预措施利大于弊	1
支持使用某项干预措施的弱推荐	利弊不确定或无论高低质量的证据均显示利弊相当	2
反对使用某项干预措施的弱推荐	证据均显示利弊相当	2
反对使用某项干预措施的强推荐	评价者确信干预措施弊大于利	1

结节性红斑病因诊断的专家共识(2025版)

Expert consensus on the etiology and diagnosis of erythema nodosum (2025 version)

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病因	分类
感染	链球菌感染、结核分枝杆菌感染、其他(如细菌、真菌和病毒等)感染
自身免疫	白塞综合征、炎症性肠病、系统性红斑狼疮、大动脉炎、结节病、其他(如干燥综合征、类风湿关节炎等)
肿瘤	霍奇金淋巴瘤、白血病、淋巴瘤(如B细胞淋巴瘤、Lennert淋巴瘤、非霍奇金淋巴瘤、T细胞丰富的B细胞淋巴瘤)
药物	化学制剂、生物制剂及免疫检查点抑制剂、疫苗等
特发性	未明确病因及分类

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