Highlights & Basics
- Erythema nodosum presents with tender, nonulcerated, erythematous nodules located most commonly over the shins, and may sometimes be associated with arthralgia and fever.
- Lesions occur as a response to a variety of conditions, including infection, chronic inflammatory disease, autoimmune disease, malignancy, and pregnancy. They are also related to the ingestion of certain medications.
- Histopathology demonstrates a septal panniculitis without vasculitis. Miescher radial granulomas are a diagnostic feature, but are not necessary for confirmation.
- Treatment consists of supportive care, including bed rest and leg elevation, as well as nonsteroidal anti-inflammatory drugs (NSAIDs), potassium iodide, and intralesional or oral corticosteroids. Nodules may also resolve spontaneously. Healing occurs without atrophy or scarring.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
Erythema nodosum lesions on skin of back due to hypersensitivity to antigens of Coccidioides immitis
Singular erythema nodosum mimicking cellulitis, the most common lesion associated with inflammatory bowel disease, ulcerative colitis, and Crohn disease (4-6% of patients, most often women ages 10-30 years)
Erythema nodosum on the shin of a patient.
Erythema nodosum on a patient's arms and hands
Erythema nodosum on a patient's arm
Erythema nodosum on a patient's arm
Pancreatic panniculitis in a 56-year-old male with neurofibromatosis 2 (NF2) and erythema nodosum (prednisone 10 mg daily)
Pancreatic panniculitis in a 56-year-old male with neurofibromatosis 2 (NF2) and erythema nodosum (prednisone 10 mg daily)
Subcutaneous panniculitis-like T cell lymphoma in a 69-year-old female with hepatitis B, thyroid cancer, and recent insect exposure while gardening
Subacute nodular migratory panniculitis
Erythema nodosum on a patient's leg
Citations
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Sterling JB, Heymann WR. Potassium iodide in dermatology: a 19th century drug for the 21st century-uses, pharmacology, adverse effects, and contraindications. J Am Acad Dermatol. 2000 Oct;43(4):691-7.[Abstract]
Friedman ES, LaNatra N, Stiller MJ. NSAIDs in dermatologic therapy: review and preview. J Cutan Med Surg. 2002 Sep-Oct;6(5):449-59.[Abstract]
Schultz E, Whiting D. Treatment of erythema nodosum and nodular vasculitis with potassium iodides. Br J Dermatol. 1976 Jan;94(1):75-8.[Abstract]
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