Erythema nodosum

Question 1

What is erythema nodosum?

What are the presenting features?

Answer 1

Presents with:

=> Painful, tender, dusky bruise like swellings over the shin

=> Fades over a few weeks

=> Most common in young women

=> Assoc. arthralgia, malaise, fever, inflammation in deeper dermis & subcutaneous fat

Question 2

What is the treatment?

Answer 2

Management:

=> symptomatic relief with NSAIDs, light compression socks and rest

=> Treat underlying cause

=> Persistent cases = treat with anti-inflammatory i.e. colchicine or prednisolone

Question 3

What are the causes of erythema nodosum?

Answer 3

NODOSUM mneumonic:

NO cause i.e. idiopathic (60%)

Drugs i.e. sulphonamides, oral contraceptive pill

Oral contraceptives

Sarcoidosis

Ulcerative colitis ; crohn’s disease ; Bechet’s

Microbiology i.e. streptococcal infection, TB, bacterial, fungal causes