Erythema nodosum EN , is an inflammatory condition characterized by inflammation of the fat cells under the skin , resulting in tender red nodules or lumps that are usually seen on both shins. The first signs of erythema nodosum are often flu-like symptoms such as a fever, cough, malaise , and aching joints. Some people also experience stiffness or swelling in the joints and weight loss. These subcutaneous nodules can appear anywhere on the body, but the most common sites are the shins, arms, thighs, and torso. Each nodule typically disappears after around two weeks, though new ones may continue to form for up to six or eight weeks.
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DermNet provides Google Translate, a free machine translation service. Note that this may not provide an exact translation in all languages. October Erythema nodosum is a type of panniculitis , an inflammatory disorder affecting subcutaneous fat.
It presents as tender red nodules on the anterior shins. Less commonly, they affect the thighs and forearms [1—3]. Erythema nodosum can occur in all ethnicities, sexes, and ages, but is most common in women between the ages of 25 and 40 .
In other cases, it is associated with an identified infection , drug, inflammatory condition, or malignancy . Erythema nodosum presents with tender bilateral erythematous subcutaneous nodules 3—20 cm in diameter erupting over one to several weeks.
They are accompanied by fever and joint pain. The knees and other joints can also be affected . Erythema nodosum has few known complications and lesions usually resolve spontaneously. Erythema nodosum is primarily a clinical diagnosis confirmed by laboratory tests and histopathology . The pathology of erythema nodosum shows inflammation primarily of the septa between the subcutaneous fat lobules without vasculitis .
A range of causes of panniculitis should be considered in a patient with subcutaneous nodules, especially if lesions are not located on the legs, there is ulceration, or symptoms last longer than eight weeks. Panniculitis can be predominantly septal inflammation between lobules or lobular inflammatory cells within subcutaneous fat lobules .
Mixed septal and lobular inflammation can occur. Erythema nodosum is treated based on the underlying disease. An underlying infection should be treated. Erythema nodosum follows a relatively benign and favourable course. It is important to recognise the underlying cause, if any, and initiate symptomatic treatment .
Most cases resolve within days to weeks. See smartphone apps to check your skin. DermNet NZ does not provide an online consultation service. If you have any concerns with your skin or its treatment, see a dermatologist for advice. Erythema nodosum — codes and concepts open. Reaction to external agent. Septal panniculitis, Causes of erythema nodosum, Clinical features of erythema nodosum, Investigations of erythema nodosum, Treatment of erythema nodosum.
EB31, 4B Vasculitis, neutrophilic dermatoses and related disorders. Wiley-Blackwell, Hoboken Vol 3, Patterson JW. In: Dermatology. Elsevier Saunders, Philadelphia Leucocyte activation in erythema nodosum. Clin Exp Dermatol ; Erythema, Nodosum. StatPearls Publishing. Updated 12 December Erythema nodosum.
A review. Cutis ;21 6 Erythema nodosum and associated diseases. A study of cases. Int J Dermatol ;— Erythema nodosum: a sign of systemic disease. Am Fam Physician ; New York: McGraw-Hill, , Am Fam Physician ;— Erythema nodosum in children: a prospective study. J Am Acad Dermatol ;— Part I. Mostly septal panniculitis. Erythema nodosum: an experience of 10 years.
Scand J Infect Dis ;—7. PubMed Patterson JW. Weedon D. Churchill Livingstone, Erythema nodosum from Yersinia enterocolitica. Br J Dermatol ;— Journal Pink A, Barker J. Successful therapy of refractory erythema nodosum associated with Crohn's disease using potassium iodide.
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NCBI Bookshelf. Wissem Hafsi ; Talel Badri. Authors Wissem Hafsi 1 ; Talel Badri 2. These nodules are characterized by a typical histological appearance regardless of the etiology, marked by acute inflammation of the dermo-hypodermic junction and interlobular septa of the hypodermic fat, evolving without necrosis or sequelae.