Erythema Nodosum

Erythema Nodosum usually appears as reddish lumps on the shins. These are usually tender or painful and can range is size from 1 – 5 centimeters (a dime to a quarter). The condition will usually resolve by itself within three to six weeks. Younger adults, particularly women are more prone to this condition, and it can reoccur over a period of months or years.

Symptoms

Reddish lumps or bumps over both shins that slowly change in color and tenderness much as a bruise would progress. Fever and/or joint pain may also be present.

Causes

In the majority of cases, the exact cause of this skin condition is unknown. We do know that it affects the fatty layer just underneath the skin.

However, it does appear to be an immunologic response to a variety of suspected triggers, including:

• Infections (e.g. tuberculosis, Mycoplasma, streptococcal, and Epstein-Barr virus)
• Autoimmune Disorders like Behcet’s disease
• Pregnancy
• Sarcoidosis
• Inflammatory Bowel Diseases like Crohn’s disease and Ulcerative Colitis
• Certain Medications (e.g. sulfonamides, oral contraceptives)

Treatment

Treatment usually starts with the cause if it’s known (e.g. strep throat). Treatment of the symptoms centers on reducing the nodule inflammation and pain. NSAIDs (nonsteroidal anti-inflammatory drugs) can be helpful to reduce the pain. Corticosteroids, colchicine and/or potassium iodide are also used in more severe or chronic cases.

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