Condition- Erythema Nodosum

Question 1

What is erythema nodosum?

Answer 1

Panniculitis (inflammation of subcutanous fat)

Question 2

Which type of hypersensitivity reaction is erythema nodosum?

Answer 2

Type 4- delayed hypersensitivity

Question 3

List some causes of Erythema nodosum

Answer 3

• Infectious- Strep pyogenes, TB, HIV
• Systemic- IBD, malignancy, Behcet’s Disease
• Drugs- sulphonamides
• Pregnancy
• BCG vaccination

Question 4

Which gender and age group does erythema nodosum usually occur in?

Answer 4

Young Females

Question 5

Young female presents with these lesions on her legs and with a couple on her arms. PMHx had a sore throat 2 weeks ago which resolved.

Which dermatological lesion can be seen below. Decribe some of its characterisic features and any associated symptoms you might look out for

Answer 5

ERYTHEMA NODOSUM

• Raised red/violet tender nodules
• Usualy on shin but may appear on arms
• May have FLAWS + low-grade pyrexia
• May have joint pain on movement

Question 6

A young female patient comes into the GP practice with these lesions on her legs and her arms. On further questioning she states that she has noticed that she’s been more tired at the end of the day and has had a low temperature. What is this lesion and which investigations would you conduct to find out the cause?

Answer 6

ERYTHEMA NODOSUM- red/violet lesions bilateral shins. Young female.

• Bloods:
  
  • FBC, CRP, ESR- to check for systemic inflammation (Crohn’s=> OGD)
  • anti-streptolysin-O titre- to rule of Strep pyogenes as the cause
• Throat swab for strep as well
• Mantoux test and CXR- for TB