Erythema Nodosum

 

Condition that causes red nodules (rounded lumps) to form just below the skin surface, most commonly on the shins. In most people, no specific cause or trigger can be found. But in some people a trigger (commonly a streptococcal infection or sarcoidosis) can be identified. Could you be suffering from this condition? Contact Us To Schedule An Appointment!

Erythema Nodosum

Erythema nodusum is an inflammation of the fat cells under the skin (panniculiis) characterized by tender red nodules or lumps that are usually seen on both shins.  There are a variety of different causes, as this is due to an immunologic response.  This condition tends to result in reddish, painful, tender lumps most commonly located in the front of the legs below the knees. The tender lumps or nodules, of erythema nodosum range in size from one to five centimeters.  The nodular swelling is caused by a special pattern of inflammation in the fatty layer of skin.  This condition can resolve on its own in three to six weeks.  This may leave a temporary bruised appearance or leave a chronic indentation in the skin where the fatty layer has been injured.
 
Cause of Erythema Nodosum:
Erythema Nodosum will often occur with other conditions, but in 30-50% of cases the cause is unknown. Conditions that are associated with erythema nodosum are certain use of medications (such as birth-control pills and 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.
 
Signs and Symptoms of Erythema Nodosum:
The most characteristic symptom associated with this disease is raised, tender, reddish nodules, which are most commonly below the knees in the front of the legs.  They are typically painful and can slowly come and go.  These areas range in size from a dime to a quarter and they may be tender and inflamed off and on for a period of weeks.  These areas will usually resolve on their own, and will become flat rather than raised and inflamed.  They will leave a bruised appearance, and then completely clear.  Other lesions may pop up in other areas, and this may occur for periods of weeks to months, and then they will eventually go away.  If this condition is classified as chronic it may last for years, with intermittent recurrences.
 
Treatment of Erythema Nodusum:
The first course of treatment is to identify the underlying condition present that may be causing this disease.  Once that is identified the process is to treat the inflamed lesions on the skin.  These treatments include anti-inflammatory drugs, and cortisone by mouth or local injection.  Colchicine is sometimes used effectively to reduce inflammation and prevent recurrence.  The long term outlook of this condition is very good with treatment, as this condition does not threaten internal organs.
 
 
Additional Resources:
 
Erythema Nodosum
Erythema Nodosum Overview (link to NIH)
  
En Espanol
Edema nudoso (link to NIH)