Erythema nodosum is a painful red nodular rash that may be a manifestation of numerous systemic diseases.
Erythema nodosum is three to five times more common in female patients .
Erythema nodosum appears as painful erythematous nodules over the shins approximately 1-6 cm in size and are usually distributed symmetrically. Systemic symptoms (e.g. fever) may also be present depending on the underlying condition .
The rash is caused by panniculitis (inflammation of the subcutaneous fat) and is thought to be due to a type IV hypersensitivity .
Multiple causes of erythema nodosum have been described :
- post-infectious (most common Streptococcal infection)
- infection (e.g. tuberculosis)
- sarcoidosis (see cutaneous manifestations of sarcoidosis)
- drug-related (e.g. oral contraceptive pill)
- inflammatory bowel disease
- paraneoplastic syndromes (e.g. Hodgkin disease, leukemia)
Treatment and prognosis
Typically the lesions are self-limiting and resolve within a few weeks. Underlying disorders however should be investigated for and treated .
- Morbus Crohn
- Morbus Behçet
- Colitis ulcerosa
- Rheumatisches Fieber