Erythema nodosum is an eruption of tender red lumps on both shins and occasionally the arms and face. Bruising often accompanies the nodule formation. Erythema nodosum is most prevalent in young adults.
Causes and symptoms
Erythema nodosum can be caused by many important and treatable diseases. Among them are tuberculosis, several fungal lung infections, leprosy, inflammatory bowel disease, and some potentially dangerous bacterial infections. Drugs can also induce erythema nodosum. The most common are penicillin, sulfonamides, and birth control pills.
There are a few other skin eruptions that mimic erythema nodosum, so the physician may have to perform a biopsy to sort them out. There are a few types of panniculitis, fat inflammation, that may signal a cancer somewhere in the body, and there are other kinds of inflammation that may confuse the diagnosis.
Once the skin problem has been diagnosed, its underlying cause must then be identified. A lengthy evaluation may ensue, and often times the cause remains unknown.
Painful nodules can be treated with mild pain killers and local application of ice packs. Medical attention will be directed toward the underlying disease.
The nodules will eventually disappear, leaving no trace behind.
Bennett, J. Claude, and Fred Plum, eds. Cecil Textbook of Medicine. Philadelphia: W. B. Saunders Co., 1996.
Berger, Timothy G., "Skin and Appendages." In Current Medical Diagnosis and Treatment, 1996. 35th ed. Ed. Stephen McPhee, et al. Stamford: Appleton & Lange, 1995.
Bondi, Edward E., and Gerald S. Lazarus. "Panniculitis." In Dermatology in General Medicine, ed. Thomas B. Fitzpatrick, et al. New York: McGraw-Hill, 1993.
J. Ricker Polsdorfer, MD
Biopsy—Surgical removal of tissue for diagnostic purposes.
Panniculitis—Inflammation of fatty tissue.