Erythema Nodosum Associated with Kerion: A Case Series and Narrative Review of the Literature
Abstract
:1. Introduction
2. Materials and Methods
2.1. Case Series
2.2. Review of the Literature
3. Results
3.1. Case 1
3.2. Case 2
3.3. Case 3
3.4. Literature Review
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Number of Patients (n = 23) | |
---|---|
Gender, n (%) | |
| 16 (69.57%) |
| 7 (30.43%) |
Age, years ± IQR | 8 (6.5–9) |
Onset of kerion, days ± IQR | 14.5 (13.75–28.5) |
Location of kerion, n (%) | |
| 8 (34.78%) |
| 6 (26.08%) |
| 4 (17.39%) |
| 2 (8.7%) |
| 2 (8.7%) |
| 1 (4.35%) |
Lymphadenopathy, n (%) | 6 (26.08%) |
History of contact animals, n (%) | 7 (30.43%) |
Culture of pathogen, n (%) | |
| 18 (78.25%) |
| 1 (4.35%) |
| 1 (4.35%) |
| 1 (4.35%) |
| 1 (4.35%) |
| 1 (4.35%) |
EN location, n (%) | |
| 10 (43.48%) |
| 8 (34.78%) |
| 3 (13.04%) |
| 1 (4.35%) |
| 1 (4.35%) |
| |
| 21 (91.3%) |
| 2 (8.7%) |
EN develop before receiving antifungal treatment | 10 (43.49%) |
EN developed after initiating antifungal treatment | 12 (52.17%) |
Time from treatment to onset EN, days ± SD | 11.58 (7.3%) |
Treatment, n (%) | |
| 20 (86.95%) |
| 1 (4.35%) |
| 2 (8.7%) |
Healing time of EN, days ± SD | 8.31 (4.15) |
Treatment duration for kerion, weeks ± IQR | 6 (6–8) |
Authors/Year | Country | Gender/Age (Years) | Onset of Kerion (Days) | Kerion Location | History of Contact Animals | Culture | EN Location/Other Id Reaction | Time in Days from Treatment to Onset EN | Treatment | Healing Time of EN (Days) | Treatment Duration for Kerion (Weeks) |
---|---|---|---|---|---|---|---|---|---|---|---|
Our series | Mexico | M/8 | 7 | Occipital scalp + cervical lymphadenopathy | No | Trichophyton mentagrophytes ^ | Shins | Before treatment | Griseofulvin 25 MKD | 7 | 4 |
F/8 | 15 | Occipitoparietal scalp | No | Trichophyton mentagrophytes ^ | Shins | 7 | Itraconazole 5 MKD + prednisolone 1 MKD | 7 | 6 | ||
F/5 | 7 | Occipital scalp | No | Trichophyton mentagrophytes ^ | Shins/Erythmatous scaly plaques on trunk and face | Before treatment | Itraconazole 5 MKD + prednisolone 1 MKD | 7 | 6 | ||
Herzum et al. 2024 [9] | Italy | M/7 | 30 | Scalp + occipital lymphadinopathy | No | Microsporum canis | Legs | Before treatment | Griseofulvin 20 MKD | NA | 8 |
Salah et al. 2021 [10] | Tunisia | M/14 | NA | Vertex | NA | Trichophyton mentagrophytes | Legs | 14 | Griseofulvin | 1 | NA |
M/9 | NA | Vertex | NA | Trichophyton mentagrophytes | Legs | 7 | |||||
M/4 | NA | Vertex | NA | Trichophyton mentagrophytes | Legs | 20 | |||||
Romano et al. 2016 [2] | Italy | F/4 | 13 | Scalp + cervical lymphadenopathy | Cat | Trichophyton mentagrophytes ^ | Lower legs/Erythematous papular lesions on ears, abdomen and back | 2 | Griseofulvin 20 MKD + oral betamethasone | 9 | 8 |
Kelati et al. 2016 [11] | Morroco | M/9 | 15 | Vertex | Dogs | Trichophyton mentagrophytes | Legs, forearms * | Before treatment | Griseofulvin 25 MKD | NA | 6 |
Mohamed et al. 2016 [7] | Tunisia | M/7 | 14 | Temporal scalp | Rabbit | Trichophyton mentagrophytes | Legs * | Before treatment | Griseofulvin 20 MKD + topical econazole + mefenamic acid 500 mg/day | 7 | 6 |
Castriota et al. 2013 [12] | Italy | F/9 | 48 | Occipital scalp + Retronuchal lymphadenopathy | Rabbit, dogs | Trichophyton mentagrophytes ^ | Legs * | 14 | Griseofulvin 25 MKD + topical mupirocin and tioconazole + prednisone 1 MKD | 10 | 6 |
Zaraa et al. 2012 [1] | Tunisia | M/7 | 60 | Occipitopariental scalp + cervical lymphadenopathy | No | Mega sporic parasitism ^ | Shins, thighs */Erythematous patches on trunk | 18 | Griseofulvin 25 MKD + ciclopirox olamine cream | 7 | 12 |
Bassi et al. 2009 [13] | UK | F/8 | 8 | Vertex + cervical lymphadenopathy | Pet rats | Trichophyton mentagrophytes | Shins, thighs | 1 | Griseofulvin 10 MKD | 10 | 6 |
Morrone et al. 2011 [14] | Italy (Philippine nationality) | F/35 | 21 | Vertex ^ | No | Trichophyton mentagrophytes ^ | Pretibial area * | Before treatment | Terbinafine 250 mg/day + naproxen 1 g/day | 15 | 8 |
Soria et al. 2008 [15] | Spain | M/11 | NA | Parietal scalp | NA | Trichophyton mentagrophytes | Lower legs | 26 | Griseofulvin + Ibuprofen | 7 | NA |
M/9 | NA | Scalp | NA | Trichophyton mentagrophytes | Lower legs | 16 | Griseofulvin | 7 | NA | ||
Provini et al. 2003 [16] | Italy | M/3 | 56 | Scalp | NA | Epidermophyton floccosum | Lower legs | Before treatment | Griseolfuvin+ topical eosine and myconazole | NA | NA |
Calista et al. 2001 [8] | Italy | F/5 | 14 | Right parietal scalp | No | Trichophyton mentagrophytes | Shins, thighs | Before treatment | Griseofulvin 18 MKD + topical crystal violet | 10 | 6 |
De las Heras et al. 1991 [17] | Spain | M/9 | 7 | Scalp | Rabbitsdogs | Trichophyton mentagrophytes | Shins * | Before treatment | Griseofulvin 10 MKD + topical tioconazole | 12 | 6 |
Martinez-Roig et al. 1982 [18] | Spain | M/8 | NA | Occipital scalp | NA | Trichophyton mentagrophytes | Shins | 7 | Griseofulvin + topical potassium permanganate solution | 12 | NA |
M/6 | NA | Occipital scalp | NA | Trichophyton mentagrophytes | Shins | 7 | 12 | NA | |||
M/3 | NA | Occipital scalp | NA | Trichophyton mentagrophytes | Shins | 7 | 12 | NA | |||
Stocker et al. 1977 [19] | USA | F/12 | NA | Scalp | NA | Trichophyton verrucosum | Shins | Before treatment | Griseofulvin | NA | NA |
Velasco et al. 1975 [20] | Spain | M/7 | NA | Scalp | NA | Trichophyton mentagrophytes | Legs | NA | Griseofulvin | NA | NA |
Smith et al. 1963 [21] | UK | M/7 | 14 | Occipitopariental scalp + cervical adenitis | White mouse | Trichophyton mentagrophytes | Lower legs | Before treatment | Griseofulvin + topical tioconazole | NA | NA |
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Rattananukrom, T.; Uh-Sánchez, I.; Atoche-Dieguez, C.; Eljure, N.; Garcia-Rementeria, C.; Arenas, R. Erythema Nodosum Associated with Kerion: A Case Series and Narrative Review of the Literature. J. Fungi 2025, 11, 103. https://doi.org/10.3390/jof11020103
Rattananukrom T, Uh-Sánchez I, Atoche-Dieguez C, Eljure N, Garcia-Rementeria C, Arenas R. Erythema Nodosum Associated with Kerion: A Case Series and Narrative Review of the Literature. Journal of Fungi. 2025; 11(2):103. https://doi.org/10.3390/jof11020103
Chicago/Turabian StyleRattananukrom, Teerapong, Isaías Uh-Sánchez, Carlos Atoche-Dieguez, Nixma Eljure, Carlos Garcia-Rementeria, and Roberto Arenas. 2025. "Erythema Nodosum Associated with Kerion: A Case Series and Narrative Review of the Literature" Journal of Fungi 11, no. 2: 103. https://doi.org/10.3390/jof11020103
APA StyleRattananukrom, T., Uh-Sánchez, I., Atoche-Dieguez, C., Eljure, N., Garcia-Rementeria, C., & Arenas, R. (2025). Erythema Nodosum Associated with Kerion: A Case Series and Narrative Review of the Literature. Journal of Fungi, 11(2), 103. https://doi.org/10.3390/jof11020103