ERYTHEMA NODOSUM

Description

  • Skin inflammation that is located in a part of the fatty layer of skin

Symptoms

  • Reddish, painful, tender lumps
  • Fever
  • General aching
  • Feeling unwell (malaise)
  • Joint aches or arthralgias
  • Conjunctivitis (less frequent)
  • Lesions in other areas

Causes

  • Throat infections
  • Medications (sulfa-related drugs, birth control pills, estrogens)
  • Fungal diseases
  • Infectious mononucleosis, sarcoidosis
  • Behcet’s disease
  • Inflammatory bowel diseases
  • Normal pregnancy
  • Sarcoidosis
  • Tuberculosis
  • Other drugsI(sulphonamides, saliclyates) etc

Risk Factors

  • Age: 18-34 years
  • Gender:Women are affected more often than men
  • People associated with recent infection or illness.

Diagnostic Tests

  • Physical examination
  • Biopsy
  • Throat swab
  • Sputum or gastric washing if TB is suspected
  • Complete blood count and C-reactive protein (CRP) and/or erythrocyte sedimentation rate (ESR)
  • ASO titre (a test for streptococcal infection)
  • Chest X-ray (looking for TB and sarcoidosis)
  • Virus studies
  • Yersinia titres
  • Mantoux test or QuantiFERON gold (tests for TB)

Differential Diagnosis

  • Acute Urticaria
  • Erysipelas
  • Erythema Induratum (Nodular Vasculitis)
  • Familial Mediterranean fever
  • Insect Bites
  • Superficial Thrombophlebitis
  • Thrombophlebitis

Treatments

  • Treatment is directed toward the inflamed skin
  • Customized for the particular patient
  • Treating an underlying condition
  • Bed rest
  • Firm supportive bandages or light compression stockings
  • Anti-inflammatory medications

Medications

  • Cortisone by mouth or injection
  • Colchicine to reduce inflammation
  • Potassium iodide
  • Oral tetracyclines have anti-inflammatory properties

Lifestyle Management

  • Having cool wet compresses
  • Complete bed rest
  • Maintaining proper hygiene
  • Washing hands often with a good anti-bacterial soap
  • Avoiding sharing utensils, food, and drink
  • Avoiding the sun when taking certain medications