Pronounced: AIR-uh-THEE-ma no-DOSE-um
Erythema nodosum is the name given to extremely tender lumps on the legs and sometimes the arms. They are caused by inflammation of the fat beneath the skin. The bumps look like bruises. They change color in the same way, from pink to blue to brown. They are often accompanied by fever, joint pain, and redness around the eyes. They may continue to erupt for a week to 10 days. They will eventually resolve. It often resolves within 1-2 months.
Erythema nodosum is thought to be a type of allergic reaction. It may be caused by:
- Streptococcal infections ( strep throat]]> , tonsillitis, ]]>rheumatic fever]]> )
- Various viral infections (eg, ]]>infectious mononucleosis]]> and ]]>hepatitis B]]> )
- Fungal lung infections (coccidioidomycosis, ]]>histoplasmosis]]> )
- ]]>Psittacosis]]> (parrot fever)
- Lymphogranuloma venereum (an uncommon sexually transmitted disease)
- Leprosy (Hansen’s disease)
- Inflammatory conditions
- Sulfa drugs
- Birth control pills
- Unknown causes
This condition is rare. Having any of the causes listed above will only slightly increase your risk of the disorder. It is more common in:
- Young adults (20-30 years old)
If you have some of these, do not assume it is erythema nodosum. Have your doctor examine any sores.
- Very tender deep-seated lumps, like bruises, usually located on your shins
- Associated joint pain and fever
Your doctor will ask about your symptoms and medical history. A physical exam will be done. You may be referred to a doctor that focuses in skin problems (dermatology) or infectious diseases.
Tests may include the following:
- Blood and urine samples
- Cultures of various bodily fluids
- Chest x-ray]]> and other imaging tests
- PPD (skin test for tuberculosis)
- Biopsy of a lesion—a sample is taken to be examined under a microscope
If a cause can be identified, it will be treated. For the nodules themselves, pain relief is all that is needed. They tend to resolve on their own in about six weeks. They will not cause scarring. Treatment options include the following:
- Bedrest and elevation of legs
- Wet compresses
- Aspirin]]> or similar nonsteroidal anti-inflammatory
- 300-600 milligrams per day for up to two months may alleviate the discomfort (but iodides can also cause the problem)
This may be necessary in severe cases.
American Academy of Dermatology
American Osteopathic College of Dermatology
University of Maryland Medical Center
Canadian Dermatology Association
Beers MH, Berkow R. The Merck Manual . 17th ed. Merck & Co. West Point PA; 1999.
DermAtlas. Johns Hopkins University. Available at: http://dermatlas.med.jhmi.edu/derm/result.cfm?Diagnosis=31 . Accessed September 15, 2005.
Erythema nodosum. The Australasian College of Dermatologists Available at: http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Erythema_nodosum?OpenDocument . Accessed September 15, 2005.
Requena L, Yus ES. Erythema nodosum. Dermatol Clin . 2008;26(4):425-38, v. Review.
Last reviewed January 2009 by ]]>Ross Zeltser, MD]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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