Erythema Nodosum – Causes, Symptoms and Treatment

Erythema nodosum is a type of skin inflammation that occurs in the fat layer of the skin. Erythema nodosum is reddish, painful, and there are soft lumps that often occur in the forelegs, below the knee. Soft lumps, or nodules of Erythema nodosum of various sizes. This disease will affect the skin more or less for several weeks, then it will dry up and become flat, leaving scars like bruises.

Erythema nodosum can disappear on its own in 3-6 weeks. After disappearing, the skin will look like a temporary bruise or a chronic curve in the skin where the fat layer is affected.

Chronic Erythema nodosum is a condition of lesions that appear in other areas, over a periodof several weeks to months. However, chronic Erythema nodosum can last for years in other patterns. Chronic Erythema nodosum is usually recurrent and can be treated if the underlying underlying disease is treated.

Causes of Erythema Nodosum

Erythema nodosum is idiopathic or the cause is unknown. In some cases, Erythema nodosum is the result of an abnormal immune response, most often triggered by infections, drugs, or conditions that cause chronic inflammation, such as strep throat, fungal diseases, mononucleosis, sarcoidosis, Behcet’s disease, inflammatory bowel disease (Crohn’s disease and ulcerative colitis), and normal pregnancy.

Researchers are not entirely sure how Erythema nodosum develops. One theory is that it may be caused by a buildup of immune complexes in small blood vessels and connections in subcutaneous fat. This buildup causes inflammation.

About 1.2 percent of leprosy patients develop a type of Erythema nodosum called Erythema nodosum leprosum or type 2 leprosy reaction.

Possible causes of Erythema nodosum, such as launching Medical news Today, include:

  • Infections, such as streptococcal pharyngitis or strep throat
  • Bacterial infections, such as Mycoplasma pneumonia or tuberculosis
  • Virus infection
  • Deep fungal infections
  • Sarcoidosis – inflammation in several parts of the body
  • Cancer
  • Antibiotics
  • Oral contraception
  • Pregnancy
  • Conditions that cause chronic inflammation, such as inflammatory bowel disease (IBS), ulcerative colitis (UC), and Crohn’s disease
  • Sulfonamides, salicylates, and other non-steroidal anti-inflammatory drugs (NSAIDs)
  • Bromide and iodide
  • Genetics

Symptoms of Erythema Nodosum

Erythema nodosum can develop suddenly without any warning signs. Some people experience nonspecific symptoms before the Erythema nodosum lesions develop.

Many early signs of Erythema nodosum, especially joint pain, continue after the wound develops and can last for weeks to months after disappearing.

Common early signs and symptoms of Erythema nodosum include:

  • Fever
  • Fatigue without cause
  • Lung, throat, or nasal infection
  • Joint pain, muscle and weakness
  • Swollen joints, often occur on the ankles and knees
  • Infection or inflammation
  • Cough
  • Weight loss

Symptoms vary between individuals, but once the Erythema nodosum lesion develops, it usually has several general characteristics.

Most Erythema nodosum injuries usually:

  • Very painful
  • Hot to the touch
  • Bright red for a week to 10 days then fades to purple or blue
  • Both sides of the body are the same
  • On the front of the shin, but sometimes the ankles, knees, thighs and forearms
  • Slightly raised lump
  • Round shape
  • Watery lumps of skin
  • The size of the lump varies from small like grapes to oranges, but mostly between 1-5 centimeters
  • The number of bumps between 2 to more than 50
  • Sparkling bump

Rarely, the spots can be joined together to form a crescent-like ring that spreads for several days before fading.

Diagnosis of Erythema Nodosum

The first doctor will do a physical examination that has a rash. However, a biopsy – a procedure in which a small part of the affected skin is taken for more thorough examination, is usually needed to confirm the diagnosis of Erythema nodosum.

Treating Erythema Nodosum

Erythema nodosum is initially treated by identifying and treating the underlying condition, along with skin lesions.

Treatments for Erythema nodosum include anti-inflammatory drugs, and cortisone by mouth or injection. Colchicine is sometimes used effectively to reduce inflammation. Treatment must be tailored to specific patients and their symptoms. It is important to note that Erythema nodosum, irritating and often painful, does not threaten internal organs and the long-term prospects are generally very good.

With proper rest, most cases of Erythema nodosum resolve on their own within 1 to 2 months, with new wounds continuing to develop or spread throughout the first few weeks.

However, some people experience symptoms of Erythema nodosum for 6 months or more. This is more likely if it is caused by an underlying medical condition or an untreated infection. Chronic or long-term Erythema nodosum will also cause joint pain.

The doctor will usually diagnose Erythema nodosum by taking a biopsy, or small tissue sample, from the wound. The recommended treatment for each case of Erythema nodosum depends on the cause. The underlying infection or medical condition will also need treatment.

Common forms of treatment for Erythema nodosum include:

  • Bed rest, especially if the swelling and pain are severe
  • Change any medication that causes Erythema nodosum, but only at the discretion of the doctor
  • Wrap the area with a handle and ice for 15 to 20 minutes, this can be done several times each day
  • Lift the affected area using a support, such as a pillow
  • Over-the-counter pain and anti-inflammatory drugs
  • Light compresses or bandages
  • Oral tetracycline or antibiotic drugs
  • Potassium iodide, usually 400 to 900 micrograms (mcg) per day for 1 month when symptoms begin
  • Steroid Cream

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