Erythema Nodosum is a type of skin inflammation that occurs in the fatty layer of the skin. Erythema Nodosum is characterized by reddish, painful, tender lumps that are most commonly found in the front of the legs below the knees. Erythema Nodosum’s tender lumps, or nodules, range in size from a dime to a quarter. They may be inflamed intermittently for weeks, then shrink and flatten, leaving a bruised appearance. Erythema Nodosum (EN) is an erythematous, nodular eruption that usually affects the extensor aspects of the lower legs. Chronic or recurrent Erythema Nodosum is uncommon, but it can occur. Erythema Nodosum is thought to be a hypersensitivity reaction that can occur in conjunction with a variety of systemic diseases or drug therapies, or it can be idiopathic. The panniculus is the site of the inflammatory reaction.
Erythema Nodosum usually clears up on its own in three to six weeks. It may only leave a temporary bruised appearance or a chronic indentation in the skin where the fatty layer has been injured after it’s gone. In up to 55% of patients, Erythema Nodosum is a hypersensitivity reaction with no known cause. In other cases, it is linked to a known infection, drug, inflammatory condition, or cancer. Symptoms include:
- Infections of the throat (streptococcal disease or viral infection)
- Primary tuberculosis (TB), a rare cause of Yersinia infection in New Zealand, causes diarrhea and abdominal pain.
- Infection with Chlamydia
- Fungal infections include histoplasmosis and coccidioidomycosis.
- Amoebiasis and giardiasis are parasitic infections.
Chronic Erythema Nodosum is a condition in which lesions appear elsewhere for weeks to months at a time. Another pattern is chronic Erythema Nodosum, which can last for years. Chronic Erythema Nodosum, with or without underlying disease, can occur with or without recurrence. Erythema Nodosum can occur alone or in conjunction with another medical condition. Medication (sulfa-related drugs, birth control pills, estrogens), strep throat, Cat scratch disease, fungal diseases, infectious mononucleosis, sarcoidosis, Behcet’s disease, inflammatory bowel diseases (Crohn’s disease and ulcerative colitis), and normal pregnancy are all linked to Erythema Nodosum.
The doctor would first examine the rash physically. To confirm a diagnosis of Erythema Nodosum, a biopsy (a procedure in which a small section of the affected skin is removed to be examined more thoroughly) is usually required. Initially, Erythema Nodosum is treated by identifying and treating any underlying conditions as well as the skin lesions. Anti-inflammatory drugs, as well as cortisone by mouth or injection, are used to treat Erythema Nodosum. Colchicines can be used to effectively reduce inflammation in some cases. Treatment must be tailored to the individual patient and their symptoms. It is important to note that Erythema Nodosum, while annoying and often painful, does not endanger internal organs and has a generally favorable long-term prognosis. Erythema Nodosum progresses in a relatively benign and favorable manner. It is critical to identify the underlying cause, if any, and begin symptomatic treatment. Most cases are resolved within a few days to a few weeks. Relapses may occur in approximately one-third of cases, and Erythema Nodosum may develop into a chronic or persistent disorder lasting 6 months to years.
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