Tender cutaneous nodules of the legs: diagnosis and clinical clues to diagnosis
Article first published online: 28 AUG 2012
© 2012 The International Society of Dermatology
International Journal of Dermatology
Volume 52, Issue 5, pages 560–566, May 2013
How to Cite
Eimpunth, S., Pattanaprichakul, P., Sitthinamsuwa, P., Chularojanamontri, L., Sethabutra, P. and Mahaisavariya, P. (2013), Tender cutaneous nodules of the legs: diagnosis and clinical clues to diagnosis. International Journal of Dermatology, 52: 560–566. doi: 10.1111/j.1365-4632.2011.05394.x
Conflicts of interest: The authors have no conflict of interest to declare.
Statement on prior presentation: None.
- Issue published online: 17 APR 2013
- Article first published online: 28 AUG 2012
Background “Tender cutaneous nodules of the legs” is a common manifestation in dermatology. Histopathological investigation is usually required for this condition, because clinical data are frequently insufficient to make a definite diagnosis.
Objective To identify and analyze the causes of patients presenting with tender leg nodules and to reveal clinical clues that could help to differentiate causes.
Materials and methods The medical records and histopathological slides of patients presenting with tender cutaneous nodules of the legs between January 2005 and December 2007 were retrospectively reviewed.
Results Of the total of 154 patients, 122 (79.2%) were female. Definite diagnoses were categorized into four groups: inflammation (84.4%); infection (5.8%); tumor (6.5%); and nonspecific (3.2%). The most common cause in the inflammation group was erythema nodosum. The infections found were Acremonium spp., Penicillium sp., Mycobacterium abscessus, Mycobacterium fortuitum and Mycobacterium leprae. The tumors included leiomyoma, leukemia cutis, and lymphomas. Clinical data that correlated with and could be used as clues for the inflammation group were female sex (P = 0.03, OR 6.43) and lower leg involvement (P = 0.03, OR 7.14).
Limitations The retrospective manner of this study is a limitation.
Conclusion Various inflammatory conditions, infections, and tumors can present as tender cutaneous nodules of the legs. Female sex and lower leg involvement were clinical data that could be used as clues for the diagnoses in the inflammation group. However, histopathological investigation is still crucial to determine a definite diagnosis in patients presenting with tender cutaneous nodules of the legs.