{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T10:46:08Z","timestamp":1789469168861,"version":"build-2803163510"},"reference-count":16,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Dermatology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background\/Objectives<\/jats:title>\n                    <jats:p>Erythema nodosum (EN) is a septal panniculitis clinically characterized by bilateral erythematous tender subcutaneous nodules typically found on the shins. While recognized as the most common form of panniculitis, it is less frequently documented in children and infants. Currently, there are no established guidelines to diagnose and manage EN in children. This review aims to consolidate current data on triggers, clinical manifestations, and treatment options, and propose a management algorithm for pediatric erythema nodosum (PEN).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic literature review of published PEN cases up to April 22, 2024, was conducted using PubMed, Embase, Cochrane, and MEDLINE databases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After full\u2010text article review, 239 articles were included, representing 959 patients. The mean age was 10.2\u2009years, ranging from 0.58 to 17.5\u2009years. Infections were the main triggers: bacterial infections in 302 patients (31.5%), predominantly streptococcal; tuberculosis in 193 patients (20.1%); followed by idiopathic cases in 80 patients (8.3%); inflammatory bowel diseases (IBD) in 66 patients (6.9%); Beh\u00e7et's disease in 61 patients (6.4%); leprosy in 38 patients (4.0%); drug related in 28 patients (2.9%); and to a lesser extent various other infectious agents, genetic diseases, vaccines, autoimmune and inflammatory conditions, and malignancies. Diagnosis relied mainly on clinical assessment, with only 111 patients (11.6%) undergoing skin biopsy. Most patients received supportive care, including NSAIDs, along with treatment of the underlying cause.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Erythema nodosum affects children. It is mainly triggered by infections. The diagnosis is primarily clinical. Supportive care is the mainstay of treatment along with addressing the underlying cause.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/pde.70346","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T09:48:01Z","timestamp":1789465681000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Triggers, Clinical Manifestations, and Management of Pediatric Erythema Nodosum: A Systematic Review"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7380-4042","authenticated-orcid":false,"given":"Florence","family":"Lagac\u00e9\u2010Thomassin","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Department of Dermatology Sherbrooke University  Sherbrooke Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4471-2952","authenticated-orcid":false,"given":"Hannah","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Sherbrooke University  Sherbrooke Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4508-6369","authenticated-orcid":false,"given":"Justin","family":"Gervais","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Sherbrooke University  Sherbrooke Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6512-9529","authenticated-orcid":false,"given":"Imane","family":"Labzagui","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Sherbrooke University  Sherbrooke Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anya","family":"Bussi\u00e8re\u2010Filion","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Sherbrooke University  Sherbrooke Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-9476-802X","authenticated-orcid":false,"given":"Kerlysha\u2010Danielle","family":"Guerrier","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Dermatology Sherbrooke University  Sherbrooke Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5420-5261","authenticated-orcid":false,"given":"Carolina Lucena","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Dermatology Sherbrooke University  Sherbrooke Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8224-4767","authenticated-orcid":false,"given":"Elio","family":"Kechichian","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Dermatology Sherbrooke University  Sherbrooke Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"e_1_2_11_2_1","first-page":"1733","volume-title":"Dermatology","author":"Patterson J. W.","year":"2017"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431\u2010023\u201004872\u2010x"},{"issue":"4","key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"601","DOI":"10.3349\/ymj.2007.48.4.601","article-title":"Erythema Nodosum: Clinicopathologic Correlations and Their Use in Differential Diagnosis","volume":"48","author":"Yi S. W.","year":"2007","journal-title":"Yonsei Medical Journal"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/pde.15096"},{"issue":"2","key":"e_1_2_11_6_1","first-page":"145","article-title":"Erythema Nodosum in Israeli Children","volume":"2","author":"Garty B. Z.","year":"2000","journal-title":"Israel Medical Association Journal"},{"issue":"4","key":"e_1_2_11_7_1","article-title":"Erythema Nodosum in Children: A Narrative Review and a Practical Approach","volume":"9","author":"Trapani S.","year":"2022","journal-title":"Children (Basel)"},{"issue":"5","key":"e_1_2_11_8_1","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0062653","article-title":"Mycobacterium tuberculosis\n                   Infection Is Associated With the Development of Erythema Nodosum and Nodular Vasculitis","volume":"8","author":"Chen S.","year":"2013","journal-title":"PLoS One"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.14740\/jocmr2011w"},{"issue":"11","key":"e_1_2_11_10_1","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1007\/s004310050728","article-title":"Conditions Currently Associated With Erythema Nodosum in Swiss Children","volume":"156","author":"Hassink R. 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C.","year":"2018","journal-title":"World Journal of Pediatrics"},{"issue":"5","key":"e_1_2_11_12_1","first-page":"438","article-title":"Erythema Nodosum Association With Malignant Lymphoma","volume":"39","author":"Pileckyte M.","year":"2003","journal-title":"Medicina (Kaunas, Lithuania)"},{"issue":"9","key":"e_1_2_11_13_1","doi-asserted-by":"crossref","DOI":"10.3390\/medicina56090425","article-title":"Dermatological Manifestations in Pediatric Inflammatory Bowel Disease","volume":"56","author":"Diaconescu S.","year":"2020","journal-title":"Medicina (Kaunas, Lithuania)"},{"issue":"3","key":"e_1_2_11_14_1","doi-asserted-by":"crossref","first-page":"525","DOI":"10.1097\/01.MIB.0000442011.60285.68","article-title":"Clinical, Serologic, and Genetic Factors Associated With Pyoderma Gangrenosum and Erythema Nodosum in Inflammatory Bowel Disease Patients","volume":"20","author":"Weizman A.","year":"2014","journal-title":"Inflammatory Bowel Diseases"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1067\/mjd.2001.110877"},{"key":"e_1_2_11_16_1","volume-title":"Erythema Nodosum: Overview of Management","author":"Kroshinsky D.","year":"2023"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.3390\/pathogens13050350"}],"container-title":["Pediatric Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pde.70346","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/pde.70346","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/pde.70346","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T09:48:04Z","timestamp":1789465684000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/pde.70346"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,15]]},"references-count":16,"alternative-id":["10.1111\/pde.70346"],"URL":"https:\/\/doi.org\/10.1111\/pde.70346","archive":["Portico"],"relation":{},"ISSN":["0736-8046","1525-1470"],"issn-type":[{"value":"0736-8046","type":"print"},{"value":"1525-1470","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,15]]},"assertion":[{"value":"2024-08-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"pde.70346"}}