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

doi:10.19982/j.issn.1000-6621.20250195

Abstract

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

CLC Number:

R758.61

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

Figures/Tables 6

References 57

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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

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