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Erythema Nodosum

Definition

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.
Erythema Nodosum
Erythema  Nodusum
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Causes

Erythema nodosum is thought to be a type of allergic reaction. It may be caused by:

Risk Factors

This condition is rare. It is more common in females and young adults aged 20-30 years old. Having any of the causes listed above will only slightly increase your risk of the disorder.
The risk factor for erythema nodosum is genetics.

Symptoms

Symptoms include:
  • Very tender, deep lumps, like bruises,
    • Usually located on your shins
    • May also appear on the forearms, trunk, neck, and head
  • Associated joint pain and fever and redness around the eyes

Diagnosis

Your doctor will ask about your symptoms and medical history. A physical exam will be done, which may diagnose the problem based on a visual exam. You may be referred to a doctor that focuses on skin problems or infectious diseases.
Your bodily fluids may be tested. This can be done with:
  • Blood and urine samples
  • Cultures
  • PPD skin test for tuberculosis
  • Biopsy of a lesion
Images may be taken of your bodily structures. This can be done with a chest x-ray and other imaging tests.

Treatment

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:

Pain Relief

Pain relief includes:
  • Bedrest and elevation of legs
  • Wet compresses
  • Aspirin , except in children
  • Nonsteroidal anti-inflammatory medication
  • Potassium iodide

Steroid Treatment

This may be necessary in severe cases.

Prevention

Some of the infectious causes can be avoided by practicing good hygiene, which includes:
  • Washing your hands often
  • Not sharing foods, drinks, or utensils

RESOURCES

American Academy of Dermatology http://www/aad.org

Dermnet NZ http://dermnetnz.org

CANADIAN RESOURCES

Canadian Dermatology Association http://www.dermatology.ca

Dermatologists.ca http://www.dermatologists.ca

References

Erythema nodosum. Updated December 26, 2012. Accessed September 18, 2013.

Erythema nodosum. Better Health Channel website. Available at: http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Erythema%5Fnodosum?OpenDocument . Updated April 2011. Accessed September 18, 2013.

Requena L, Yus ES. Erythema nodosum. Dermatol Clin. 2008;26(4):425-438, v. Review.

Revision Information