Erythema nodosum is characterized by tender, red bumps, usually found on the shins. It is one of the cardinal signs of inflammation. There are many causes and manifestations of erythema, including photosensitivity, erythema multiforme, and erythema nodusum.



Erythema is relatively common problem for a dermatologist. Half of the cases are found in young people under age 20. It is a rare both under the age of 3 and over the age of 50. Males are slightly more affected than females and there is no racial predilection.

Causes

Erythema nodosum is a type of hypersensitivity (allergic) reaction that occurs in response to medications, infections, or illness. Medications associated with erythema multiforme include sulfonamides, penicillins, barbiturates, and phenytoin.

Few important causes are-

Streptococcal infections

Sarcoidosis (inflammation of the lymph nodes and other organs)

Leprosy

Coccidioidomycosis (infection of the upper respiratory tract and lungs)

Histoplasmosis (an infectious pulmonary disease)

Tuberculosis

Psittacosis (a flu-like disease)

Lymphogranuloma venereum (a venereal infection)

Ulcerative colitis

Symptoms

The following are the most common symptoms of erythema nodosum. However, each individual may experience symptoms differently:

Malaise, fatigue, flu-like symptoms (before lesions appear)

Clustures of nodules (small round masses) and lesions on shins, forearms, thighs, and trunk

Red, hard, painful lesions become soft and bluish, and fade to yellow and brown

Joint pain

Arthritis

One to two weeks after exposure, some children will experience a low grade fever and tiredness. By the third week, a red rash generally appears on the cheeks giving a slapped face appearance. The rash may then extend to the body and tends to fade and reappear. Sometimes, the rash is lacy in appearance and may be itchy. Some children may have vague signs of illness or no symptoms at all.

The symptoms of erythema nodosum may resemble other skin conditions. Always consult your physician for a diagnosis.

Treatment

Treatment should focus on the underlying cause. Symptoms can be treated with bed rest, leg elevation, compressive bandages, wet dressings, and nonsteroidal anti-inflammatory agents.

Your physician based on will determine specific treatment for erythema nodosum depending on your age, overall health, and medical history, extent of the condition, your tolerance for specific medications, procedures, or therapies, expectations for the course of the condition and your opinion or preference.

Treatment may include:

Antibiotics

Treatment of underlying cause

Aspirin

Corticosteroids