Erythema Nodosum Associated with Kerion: A Case Series and Narrative Review of the Literature
Issued Date
2025-02-01
Resource Type
eISSN
2309608X
Scopus ID
2-s2.0-85218855785
Journal Title
Journal of Fungi
Volume
11
Issue
2
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Fungi Vol.11 No.2 (2025)
Suggested Citation
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 Vol.11 No.2 (2025). doi:10.3390/jof11020103 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/105545
Title
Erythema Nodosum Associated with Kerion: A Case Series and Narrative Review of the Literature
Corresponding Author(s)
Other Contributor(s)
Abstract
Kerion is a form of inflammatory tinea capitis, a fungal infection caused by various zoophilic, geophilic, and anthropophilic pathogens. Erythema nodosum (EN), a form of septal panniculitis, can be considered a dermatophyte id reaction that occurs outside the primary site of dermatophyte infection. The association between EN and kerion is rarely reported, with most cases following Trichophyton mentagrophytes scalp infections. Here, we describe three cases of EN associated with kerion caused by T. mentagrophytes, successfully treated with itraconazole or griseofulvin plus prednisone. Additionally, we conducted a narrative review of the literature, identifying 23 reported cases of EN associated with kerion on PubMed. The most commonly reported fungus was T. mentagrophytes (78.25%). In 52.17% of cases, patients developed EN after initiating antifungal treatment, with a mean onset time of 11.58 days (SD 7.3). Griseofulvin remains a mainstay treatment. The mean time for EN resolution was 8.31 days (SD 4.15), and the median duration of treatment for kerion leading to a complete response was 6 weeks (IQR 6–8). Scarring alopecia is a common sequela following kerion, and the use of corticosteroids has been recommended as adjunct therapy to minimize the risk of scarring.