Erythema Nodosum

What is erythema nodosum?

Erythema nodosum is a painful inflammation of the fat beneath the skin’s surface. It is characterized by lumps or nodules beneath the skin that are about an inch across and are firm, red, and warm to the touch. Over the course of several days, the lumps may turn a purplish color and then fade over the next several weeks. They usually appear on the shins but may also occur on other parts of your body, including your arms, legs and buttocks.

In more than half of all cases, the exact cause of erythema nodosum is not known, but it has been linked to other infections, most commonly strep throat. Less often, it can be the first sign of a systemic disease, such as tuberculosis, inflammatory bowel disease, bacterial or deep fungal infection, sarcoidosis (inflammatory disease most commonly affecting the lungs, skin and eyes), or, rarely, cancer. It can also be a reaction to medications, such as antibiotics or oral contraceptives. It can occur at any age and is more common in women than in men.

Erythema nodosum is not life threatening and often resolves on its own, usually over a period of six weeks. However, it can sometimes recur. Most people make a complete recovery following treatment of the underlying cause or primary disorder. In the meantime, the pain is usually manageable with a nonsteroidal anti-inflammatory drug (NSAID).

Erythema nodosum is not life threatening. In fairly rare cases, serious symptoms can occur, which are related to the underlying cause and not to erythema nodosum itself. Seek immediate medical care (call 911) for serious symptoms, such as high fever (higher than 101 degrees Fahrenheit), chest pain or pressure, difficulty breathing, rapid breathing (tachypnea) or shortness of breath, wheezing, pain with breathing, choking, and coughing up blood.

Seek prompt medical care if you have been treated for erythema nodosum but mild symptoms recur or are persistent, or if you have symptoms of strep throat, such as white patches at the back of your throat or on your tonsils. You should also seek prompt medical care if you notice swollen glands or lymph nodes in your neck, under your chin, in your armpit, or in your groin.