Erythema Nodosum (cont.)
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- What is erythema nodosum?
- What causes erythema nodosum?
- What are the signs and symptoms of erythema nodosum?
- How is erythema nodosum diagnosed?
- Can erythema nodosum be confused with other conditions?
- How is erythema nodosum treated?
- Find a local Dermatologist in your town
What are the signs and symptoms of erythema nodosum?
Characteristic features of erythema nodosum included raised, tender, reddish nodules, most commonly below the knees in the front of the legs. They are typically painful and can slowly come and go.
There are several scenarios for the outcome of erythema nodosum. Typically, these areas of nodular tenderness range in size from about a dime to a quarter and they may be tender and inflamed off and on for a period of weeks. They usually then resolve spontaneously, each one of the little areas of inflammation shrinking down and then becoming flat rather than raised and inflamed. They leave a bruised appearance. Then, they resolve completely on their own. Other lesions can sometimes pop up elsewhere. This may occur for periods of weeks to months, and then they eventually go away. However, chronic erythema nodosum that may last for years is another pattern. Chronic erythema nodosum, with intermittent recurrences, can occur with or without an underlying disease present.
How is erythema nodosum diagnosed?
Usually, erythema nodosum is a straightforward, simple diagnosis for a doctor to make simply by examining a patient and noting the typical firm area of raised tenderness that is red along with areas which have had lesions resolved, which might show a bruised-like appearance. It is not a difficult diagnosis for an experienced doctor. It does not typically require other investigative tests.
Sometimes a biopsy is done for confirmation, for example, if a patient presented with an isolated, singular area and a doctor was unable to make a diagnosis based on its appearance. The biopsy of the deeper layers of tissue of skin can prove that it is erythema nodosum. Those layers would show the specific inflammatory changes in the tissues.
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