Symptoms and Signs of Erythema Nodosum

Medical Author:
Medically Reviewed on 4/22/2022

Doctor's Notes on Erythema Nodosum

Erythema nodosum 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 like raised nodules about 2-5 cm in diameter develop over several days. 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.

Erythema nodosum 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 who develop erythema nodosum have no identified cause. However, the following conditions may commonly trigger erythema nodosum: 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).

What Are the Treatments for Erythema Nodosum?

The treatment options for erythema nodosum begin with identifying and treating any underlying condition or medicine that may cause the inflamed skin of erythema nodosum. Treatment directly for erythema nodosum may include the following:

  • Anti-inflammatory drugs
  • Corticosteroids
  • Colchicine

In general, erythema nodosum is annoying and often painful but does not threaten internal organs; most people do well, especially if the underlying causes are treated successfully.

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