Erythema nodosum
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Erythema nodosum is a painful red nodular rash that may be a manifestation of numerous systemic diseases.
Epidemiology
Erythema nodosum is three to five times more common in female patients 1.
Clinical presentation
Erythema nodosum appears as painful erythematous nodules over the shins approximately 1-6 cm in size and are usually distributed symmetrically. Systemic symptoms (e.g. fever) may also be present depending on the underlying condition 1.
Pathology
The rash is caused by panniculitis (inflammation of the subcutaneous fat) and is thought to be due to a type IV hypersensitivity 1.
Aetiology
Multiple causes of erythema nodosum have been described 2:
- post-infectious (most common Streptococcal infection)
- infection (e.g. tuberculosis)
- sarcoidosis (see cutaneous manifestations of sarcoidosis)
- pregnancy 3
- drug related (e.g. oral contraceptive pill)
- inflammatory bowel disease
- paraneoplastic syndromes (e.g. Hodgkin disease, leukaemia)
- idiopathic
Treatment and prognosis
Typically the lesions are self-limiting and resolve within a few weeks. Underlying disorders however should be investigated for and treated 1.
-<li><a href="/articles/sarcoidosis-1">sarcoidosis</a></li>- +<li>
- +<a href="/articles/sarcoidosis-1">sarcoidosis</a> (see <a title="Sarcoidosis (cutaneous manifestations)" href="/articles/sarcoidosis-cutaneous-manifestations">cutaneous manifestations of sarcoidosis</a>)</li>
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