Erythema nodosum: Difference between revisions
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{{SI}} | |||
{{Infobox medical condition | |||
| name = Erythema nodosum | |||
| image = [[File:ENlegs.JPG|left|thumb|Erythema nodosum on the legs]] | |||
| caption = Erythema nodosum on the legs | |||
| field = [[Dermatology]] | |||
| synonyms = | |||
| symptoms = [[Painful]] red nodules, usually on the [[shins]] | |||
| complications = | |||
| onset = | |||
| duration = | |||
| causes = [[Infection]], [[autoimmune disease]], [[medication]] | |||
| risks = | |||
| diagnosis = [[Clinical diagnosis]], [[biopsy]] | |||
| differential = [[Cellulitis]], [[vasculitis]], [[panniculitis]] | |||
| prevention = | |||
| treatment = [[NSAIDs]], [[corticosteroids]], treating underlying cause | |||
| medication = | |||
| prognosis = Generally good, self-limiting | |||
| frequency = | |||
| deaths = | |||
}} | |||
A condition that causes painful red nodules to form in the legs, and other places. | A condition that causes painful red nodules to form in the legs, and other places. | ||
[[File:Erythema Nodosum.jpg|alt=Erythema Nodosum|thumb|Erythema Nodosum]] | [[File:Erythema Nodosum.jpg|alt=Erythema Nodosum|left|thumb|Erythema Nodosum]] | ||
==Definition== | ==Definition== | ||
Erythema nodosum is an inflammatory disorder. It involves tender, red bumps (nodules) under the skin. | Erythema nodosum is an inflammatory disorder. It involves tender, red bumps (nodules) under the skin. | ||
==Causes== | ==Causes== | ||
In about half of cases, the exact cause of erythema nodosum is unknown. | In about half of cases, the exact cause of erythema nodosum is unknown. | ||
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* Streptococcus (most common) | * Streptococcus (most common) | ||
* Cat scratch disease | * Cat scratch disease | ||
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* Yersinia | * Yersinia | ||
* Leprosy | * Leprosy | ||
[[File:EN-TBC.PNG|alt=Erythema nodosum leg|thumb|Erythema nodosum leg]] | [[File:EN-TBC.PNG|alt=Erythema nodosum leg|left|thumb|Erythema nodosum leg]] | ||
==Medication associated EN== | ==Medication associated EN== | ||
Erythema nodosum may occur with sensitivity medications, including: | Erythema nodosum may occur with sensitivity medications, including: | ||
Antibiotics, including amoxicillin and other penicillins | Antibiotics, including amoxicillin and other penicillins | ||
* Sulfonamides | * Sulfonamides | ||
| Line 45: | Line 63: | ||
* Progestin | * Progestin | ||
* Pregnancy. | * Pregnancy. | ||
==Symptoms== | ==Symptoms== | ||
Erythema nodosum is most common on the front of the shins, but also can occur in buttocks, calves, ankles, thighs, and arms. | Erythema nodosum is most common on the front of the shins, but also can occur in buttocks, calves, ankles, thighs, and arms. | ||
==Progression== | ==Progression== | ||
The lesions begin as flat, firm, hot, red, painful lumps that are about 1 inch (2.5 centimeters) across. Within a few days, they may become purplish in color. Over several weeks, the lumps fade to a brownish, flat patch. | The lesions begin as flat, firm, hot, red, painful lumps that are about 1 inch (2.5 centimeters) across. Within a few days, they may become purplish in color. Over several weeks, the lumps fade to a brownish, flat patch. | ||
==Associated symptoms== | ==Associated symptoms== | ||
* Fever | * Fever | ||
| Line 58: | Line 73: | ||
* Skin redness, inflammation, or irritation | * Skin redness, inflammation, or irritation | ||
* Swelling of the leg or other affected area | * Swelling of the leg or other affected area | ||
==Diagnosis== | ==Diagnosis== | ||
* Punch biopsy of a nodule | * Punch biopsy of a nodule | ||
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* Chest x-ray to rule out sarcoidosis or tuberculosis | * Chest x-ray to rule out sarcoidosis or tuberculosis | ||
* Blood tests to look for infections or other disorders | * Blood tests to look for infections or other disorders | ||
[[File:Erythema nodosum new image.jpg|alt=Erythema nodosum |thumb|Erythema nodosum ]] | [[File:Erythema nodosum new image.jpg|alt=Erythema nodosum |left|thumb|Erythema nodosum ]] | ||
==Treatment== | ==Treatment== | ||
Treatment may include: | Treatment may include: | ||
* Nonsteroidal anti-inflammatory drugs ([[NSAIDs]]). | * Nonsteroidal anti-inflammatory drugs ([[NSAIDs]]). | ||
* [[Corticosteroids]], taken by mouth or given as a shot. | * [[Corticosteroids]], taken by mouth or given as a shot. | ||
| Line 76: | Line 89: | ||
* Raising the sore area (elevation). | * Raising the sore area (elevation). | ||
* Hot or cold compresses to help reduce discomfort. | * Hot or cold compresses to help reduce discomfort. | ||
[[File:Erythema nodosum - Kolkata 2012-01-03 7753.JPG|alt=Erythema nodosum|thumb|Erythema nodosum]] | [[File:Erythema nodosum - Kolkata 2012-01-03 7753.JPG|alt=Erythema nodosum|left|thumb|Erythema nodosum]] | ||
==Erythema nodosum leprae== | ==Erythema nodosum leprae== | ||
Erythema nodosum leprosum usually manifests with fever and painful erythematous nodules, but peripheral neuritis, orchitis, lymphadenitis, iridocyclitis, nephritis, periostitis and arthralgias may also occur. Mild episodes may require no therapy, or symptomatic measures such as aspirin administration may suffice. Several drugs are useful for the management of severe episodes. | Erythema nodosum leprosum usually manifests with fever and painful erythematous nodules, but peripheral neuritis, orchitis, lymphadenitis, iridocyclitis, nephritis, periostitis and arthralgias may also occur. Mild episodes may require no therapy, or symptomatic measures such as aspirin administration may suffice. Several drugs are useful for the management of severe episodes. | ||
* [[Corticosteroids]] are effective in all patients and should always be used if an acute neuritis is present to prevent permanent nerve injury. | * [[Corticosteroids]] are effective in all patients and should always be used if an acute neuritis is present to prevent permanent nerve injury. | ||
* [[Thalidomide]] (Thalomid) is extremely effective in treatment of ENL. | * [[Thalidomide]] (Thalomid) is extremely effective in treatment of ENL. | ||
* [[Clofazimine]] is also effective for the control of ENL. | * [[Clofazimine]] is also effective for the control of ENL. | ||
== External links == | == External links == | ||
{{Medical resources | {{Medical resources | ||
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| MeshID = D004893 | | MeshID = D004893 | ||
}} | }} | ||
{{Diseases of the skin and appendages by morphology}} | {{Diseases of the skin and appendages by morphology}} | ||
{{Urticaria and erythema}} | {{Urticaria and erythema}} | ||
{{Disorders of subcutaneous fat}} | {{Disorders of subcutaneous fat}} | ||
{{DEFAULTSORT:Erythema Nodosum}} | {{DEFAULTSORT:Erythema Nodosum}} | ||
[[Category:Autoimmune diseases]] | [[Category:Autoimmune diseases]] | ||
| Line 105: | Line 114: | ||
[[Category:Conditions of the subcutaneous fat]] | [[Category:Conditions of the subcutaneous fat]] | ||
[[Category:Medical mnemonics]] | [[Category:Medical mnemonics]] | ||
{{stub}} | {{stub}} | ||
Latest revision as of 16:13, 6 April 2025
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC
| Erythema nodosum | |
|---|---|
 | |
| Synonyms | |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Painful red nodules, usually on the shins |
| Complications | |
| Onset | |
| Duration | |
| Types | N/A |
| Causes | Infection, autoimmune disease, medication |
| Risks | |
| Diagnosis | Clinical diagnosis, biopsy |
| Differential diagnosis | Cellulitis, vasculitis, panniculitis |
| Prevention | |
| Treatment | NSAIDs, corticosteroids, treating underlying cause |
| Medication | |
| Prognosis | Generally good, self-limiting |
| Frequency | |
| Deaths | |
A condition that causes painful red nodules to form in the legs, and other places.
Definition[edit]
Erythema nodosum is an inflammatory disorder. It involves tender, red bumps (nodules) under the skin.
Causes[edit]
In about half of cases, the exact cause of erythema nodosum is unknown.
- Streptococcus (most common)
- Cat scratch disease
- Chlamydia
- Coccidioidomycosis
- Hepatitis B
- Histoplasmosis
- Leptospirosis
- Mononucleosis (EBV)
- Mycobacteria
- Mycoplasma
- Psittacosis
- Syphilis
- Tuberculosis
- Tularemia
- Yersinia
- Leprosy
Medication associated EN[edit]
Erythema nodosum may occur with sensitivity medications, including: Antibiotics, including amoxicillin and other penicillins
- Sulfonamides
- Sulfones
- Birth control pills
- Progestin
- Pregnancy.
Symptoms[edit]
Erythema nodosum is most common on the front of the shins, but also can occur in buttocks, calves, ankles, thighs, and arms.
Progression[edit]
The lesions begin as flat, firm, hot, red, painful lumps that are about 1 inch (2.5 centimeters) across. Within a few days, they may become purplish in color. Over several weeks, the lumps fade to a brownish, flat patch.
Associated symptoms[edit]
- Fever
- General ill feeling (malaise)
- Joint aches
- Skin redness, inflammation, or irritation
- Swelling of the leg or other affected area
Diagnosis[edit]
- Punch biopsy of a nodule
- Throat culture to rule out a strep infection
- Chest x-ray to rule out sarcoidosis or tuberculosis
- Blood tests to look for infections or other disorders
Treatment[edit]
Treatment may include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs).
- Corticosteroids, taken by mouth or given as a shot.
- Potassium iodide (SSKI) solution, most often given as drops added to orange juice.
- Other oral medicines that work on the body's immune system.
- Pain medicines (analgesics).
- Rest.
- Raising the sore area (elevation).
- Hot or cold compresses to help reduce discomfort.
Erythema nodosum leprae[edit]
Erythema nodosum leprosum usually manifests with fever and painful erythematous nodules, but peripheral neuritis, orchitis, lymphadenitis, iridocyclitis, nephritis, periostitis and arthralgias may also occur. Mild episodes may require no therapy, or symptomatic measures such as aspirin administration may suffice. Several drugs are useful for the management of severe episodes.
- Corticosteroids are effective in all patients and should always be used if an acute neuritis is present to prevent permanent nerve injury.
- Thalidomide (Thalomid) is extremely effective in treatment of ENL.
- Clofazimine is also effective for the control of ENL.
External links[edit]
| Diseases of the skin and appendages by morphology | ||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Urticaria and erythema | ||||||||||||||||
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| Disorders of subcutaneous fat | ||||||||||||||||
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