Elevated neutrophil to lymphocyte ratio as an indicator of secondary erythema nodosum, a retrospective observational study

Turk J Med Sci. 2019 Apr 18;49(2):624-634. doi: 10.3906/sag-1810-3.

Abstract

Background/aim: Erythema nodosum (EN) is an inflammatory disorder of subcutaneous tissue. Although etiopathogenesis of the disease is unknown, many predisposing factors such as infections, systemic disease, and drugs have been identified. Neutrophil to lymphocyte ratio (NLR) has been shown to be a novel inflammatory marker in many dermatological diseases. The aim of our study is to investigate NLR in EN patients and evaluate its relation to the underlying cause of the disease.

Materials and methods: Between 2014 and 2018, clinical and laboratory data of 395 patients diagnosed with EN and 395 controls were extracted from patient files. EN patients were grouped as idiopathic EN and secondary EN (EN with an identified underlying cause). Clinical and laboratory characteristics of the two groups were compared

Results: NLR was elevated in EN patients compared to controls (median of 2.38 vs. 1.55, P < 0.001). Among EN patients, NLR was also elevated in patients with secondary EN. In multivariate logistic regression model NLR (> 2.11), RDW-CV (> 13.65), and CRP (> 5.5) were identified as risk factors for secondary EN (relative risks were 17.16, 2.69, and 2, respectively).

Conclusion: Elevated NLR (> 2.11) may be used as a parameter to discriminate secondary EN from idiopathic EN.

Keywords: Erythema nodosum; neutrophil to lymphocyte ratio.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Biomarkers / metabolism
  • Diagnosis, Differential
  • Drug-Related Side Effects and Adverse Reactions / complications*
  • Drug-Related Side Effects and Adverse Reactions / metabolism
  • Erythema Nodosum / diagnosis*
  • Erythema Nodosum / etiology
  • Erythema Nodosum / metabolism
  • Erythrocyte Indices / physiology*
  • Female
  • Humans
  • Infections / complications*
  • Infections / metabolism
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Neoplasms / complications*
  • Neoplasms / metabolism
  • Neutrophils / metabolism*
  • Predictive Value of Tests
  • Retrospective Studies
  • Risk Factors

Substances

  • Biomarkers