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Erythema nodosum

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Illustrations

Erythema nodosum associated with sarcoidosis
Erythema nodosum associated with sarcoidosis
Erythema nodosum on the foot
Erythema nodosum on the foot

Definition    Return to top

Erythema nodosum is an inflammatory disorder that is characterized by tender, red nodules under the skin.

Causes    Return to top

The exact cause of erythema nodosum is unknown. Some cases may be associated with the following:

Other associated disorders include leukemia, sarcoidosis, rheumatic fever, and ulcerative colitis.

Erythema nodosum is most common on the shins, but it may also occur on other areas of the body (buttocks, calves, ankles, thighs and upper extremities). The lesions begin as flat, firm, hot, red, painful lumps approximately an inch across. Within a few days they may become purplish, then over several weeks fade to a brownish, flat patch. Systemic (whole body) findings may include fever and malaise.

The condition is more common in women than men.

Symptoms    Return to top

The characteristic tender, red nodules of erythema nodosum usually appear on the shins:

Accompanying symptoms include the following:

The red and inflamed skin symptoms may regress to a bruise-like appearance.

Exams and Tests    Return to top

The diagnosis is primarily based on the appearance of the skin nodules. Biopsy of a nodule may show characteristic changes (septal panniculitis).

Treatment    Return to top

The underlying infection, drug, or disease should be identified and treated. Nonsteroidal anti-inflammatory medications (NSAIDs) may reduce symptoms. An oral potassium iodide (SSKI) solution may produce prompt resolution of the nodules.

Corticosteroids or salicylate medications may be needed to reduce acute inflammation. Analgesics and limitation of activity may be needed to control varying amounts of pain.

Topical therapy is not generally needed, although hot or cold compresses may reduce discomfort.

Outlook (Prognosis)    Return to top

Erythema nodosum is uncomfortable, but it is usually not dangerous. Symptoms typically disappear within about 6 weeks, but may recur.

When to Contact a Medical Professional    Return to top

Call for an appointment with your health care provider if you develop symptoms of erythema nodosum.

Update Date: 10/26/2006

Updated by: Michael S. Lehrer, M.D., Department of Dermatology, University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

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