Symptoms and Signs of Erythema Nodosum

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Medically Reviewed on 3/11/2019

Doctor's Notes on Erythema Nodosum

Erythema nodosum (EN) is an inflammatory skin condition (panniculitis) that causes tender, painful red or purple bumps or nodules that usually appear on the shins but may appear at other sites (ankles, thighs, buttocks, upper body and face, for example). Signs and symptoms include development over several days and raised nodules about 2-5 cm in diameter. Joint pain, redness and/or swelling may occur along with enlarged lymph nodes in the chest. However, some symptoms may develop before the nodules appear such as joint pain, fatigue, fever, malaise and respiratory infection symptoms. EN is not considered a disease but is itself a symptom of other conditions like a hypersensitivity to a drug or other medical problems.

About 50% of people that develop EN have no identified cause. However, the following conditions may commonly trigger EN; infections (strep throat, TB, Histoplasmosis and others), drugs or medications (penicillin, sulfas, oral contraceptives, for example), pregnancy, cancer and inflammatory conditions (sarcoid, ulcerative colitis and others).

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Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.