About erythema nodosum

What is erythema nodosum?

Erythema nodosum is a type of skin inflammation that is located in a certain portion of the fatty layer of skin. Erythema nodosum (also called EN) results 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 inflammation in the fatty layer of skin.

Erythema nodosum can be self-limited and resolve on its own in three to six weeks. Upon resolution, it may leave only a temporary bruised appearance or leave a chronic indentation in the skin where the fatty layer has been injured.



What are the symptoms for erythema nodosum?

The main symptom is red, painful Bumps on the lower part of your legs. Sometimes these Bumps can also appear on your thighs, arms, torso, and face.

The lumps can be one-half inch up to 4 inches. You may have anywhere from two to 50 of them.

Erythema nodosum Bumps are painful and they may feel hot. They start out red, and then turn purple, looking like bruises as they heal. They also flatten out while healing.

The Bumps can last for two weeks. New Bumps can keep forming for up to six weeks.

Other symptoms of erythema nodosum include:

  • fever
  • fatigue
  • joint pain
  • pain in the legs
  • ankle swelling
  • enlarged lymph nodes in the chest
  • cough
  • sore throat
  • weight loss
  • stomach pain
  • diarrhea



What are the causes for erythema nodosum?

In more than half of all cases the cause is unknown. Erythema nodosum often starts after you’ve had an infection or you’ve used certain medicines. Doctors believe it may be caused by an immune system overreaction to bacteria and other substances you’re exposed to.

Causes include:

  • infections such as strep throat or tuberculosis
  • reactions to drugs such as antibiotics (sulfonamides and forms of penicillin), salicylates, iodides, bromides, and birth control pills
  • sarcoidosis, a condition that causes inflammation in many parts of the body
  • coccidioidomycosis, an infection of the lungs and upper respiratory tract
  • inflammatory bowel disease, ulcerative colitis or Crohn’s disease
  • pregnancy
  • cancer (rarely)

Erythema nodosum most often affects people ages 20 to 40. Women are six times more likely to develop it than men. However, it can happen in people of any age and in both sexes.



What are the treatments for erythema nodosum?

If a bacterial infection caused this condition, your doctor will prescribe antibiotics to treat it. You can treat erythema nodosum that’s caused by a drug reaction by stopping the medicine.

These medicines can help you manage pain and other symptoms until the lumps heal:

  • nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve) (Don’t use these if you have Crohn’s disease because they could trigger a flare.)
  • potassium iodide
  • oral steroids

Also, rest with your legs elevated and wear compression stockings while the bumps heal. And avoid irritating the bumps by wearing itchy or tight clothing.



What are the risk factors for erythema nodosum?

Erythema nodosum most often affects people ages 20 to 40. Women are six times more likely to develop it than men. However, it can happen in people of any age and in both sexes.



Is there a cure/medications for erythema nodosum?

Your healthcare practitioner will go over the best course of action for treating erythema nodosum with you based on age, general health, and medical background, size of the problem your tolerance for particular treatments, operations, or medications, expectations for how the illness will progress and
your preference or opinion.

  • Despite being painful, erythema nodosum is typically not a serious condition. In most cases, symptoms disappear after six weeks. They might reappear, though.
  • Your doctor will recommend medications to treat this problem if a bacterial infection is to blame. Stopping the medication is the only way to treat erythema nodosum brought on by a pharmacological reaction.


Until the lumps heal, the following medications can help you manage pain and other symptoms:

  • Aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve) are examples of nonsteroidal anti-inflammatory medicines (NSAIDs). If you have Crohn's disease, avoid using these because they may precipitate an attack.
  • Oral steroids with potassium iodide
  • Additionally, until the bumps heal, elevate your legs when you rest and wear compression stockings. Also, refrain from wearing tight or scratchy clothing to avoid irritating the lumps.
  • Bed rest is needed.


Symptoms
Red, tender bumps on the shins,Fever,Joint pain,Enlarged lymph nodes in the chest
Conditions
Red bumps on legs,Enlarged lymph nodes in the chest
Drugs
Potassium iodide,Advil,Motrin



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