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To the Editor.—
We read with interest the article by Salvatore and Lynch in the May 1980 Archives (116:557-558) on five cases of erythema nodosum related to pregnancy and oral contraceptive use. We would like to report a case of erythema nodosum aggravated by a drug-induced liver injury precipitated by an oral contraceptive.
Report of a Case.—
Erythema nodosum developed in a 42-year-old woman three weeks after she had an episode of pharyngitis that had been treated with sulfamethoxazole and trimethoprim (Bactrim). She had been taking 2.5 mg of lynestrenol and 0.05 mg of ethinyl estradiol (Minilyn) for two years. The laboratory studies on admission showed the following values: WBCs, 13,000/cu mm; ESR (Westergren), 104 mm/hr; SGOT, 34 units/L; SGPT, 91 units/L (normal, ≤ 20 units/L); and γ-glutamyl transpeptidase, 32 units/L (normal, ≤ 18 units/L). Alkaline phosphatase, leucine aminopeptidase, and serum bilirubin levels were within normal range. The antistreptolysin titer
Merk H, Ruzicka T. Oral Contraceptives as a Cause of Erythema Nodosum. Arch Dermatol. 1981;117(8):454. doi:10.1001/archderm.1981.01650080006008