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Erythema nodosum

Last updated: September 9, 2020

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Erythema nodosum (EN) is an inflammation of subcutaneous fat caused by a delayed hypersensitivity reaction. Women in early adulthood are commonly affected. Most cases are idiopathic, but an association with a variety of diseases, including infections and autoimmune disorders (e.g., ulcerative colitis), is possible. The characteristic lesions are painful nodules on the lower legs (particularly shins). EN is a clinical diagnosis. The condition typically heals spontaneously within a few weeks and, therefore, generally requires no more treatment than supportive care (e.g., analgesia).

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Epidemiological data refers to the US, unless otherwise specified.

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  • Symptomatic treatment
  • Treat underlying disease
  • In severe or refractory cases: systemic steroids

References:[2]

  • Usually self-limiting (within 2–8 weeks), or resolves earlier with effective treatment of underlying disease
  • Recurrence following discontinued treatment is common

References:[2][4]

  1. Hebel JL, James WD. Erythema Nodosum . Erythema Nodosum . New York, NY: WebMD. http://emedicine.medscape.com/article/1081633-overview. Updated: March 3, 2016. Accessed: June 7, 2017.
  2. Kroshinsky D, Callen J, Ofori AO, Romain PL. Erythema Nodosum. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. https://www.uptodate.com/contents/erythema-nodosum.Last updated: November 30, 2016. Accessed: June 23, 2017.
  3. Paller AS, Mancini AJ. Hurwitz Clinical Pediatric Dermatology. Elsevier Health Sciences ; 2015
  4. Gupta M, Singh K, Lehl SS, Bhalla M. Recurrent erythema nodosum: a red flag sign of hidden systemic vasculitis. BMJ Case Rep. 2013 . doi: 10.1136/bcr-2013-009507 . | Open in Read by QxMD
  5. Herold G. Internal Medicine. Herold G ; 2014