Erythema Nodosum: Symptoms And Causes

Erythema nodosum is a pores and skin situation which causes painful swollen crimson or purple bumps and mostly they’re situated on the shins. In some instances, the bumps can even kind on different components of the physique. This situation is most typical type of panniculitis, which is an irritation of the layer beneath your pores and skin. It’s typically brought on by an immune response to an an infection or a response to medication that you’ve got taken. [1]

It’s observed that about 5% of pregnant girls develop erythema nodosum. This can be because of the elevated estrogen ranges in the course of the being pregnant. The erythema nodosum is handled in a lot the identical method in the course of the being pregnant as it’s within the girls who will not be pregnant. [2] However, a number of the medicines, like NSAIDs, that are used to deal with erythema nodosum, can’t be given to pregnant girls. Compression stocking and mattress relaxation may also help to handle ache and different signs. [3]

Your obstetrician will let you know which the easiest way to manage the erythema nodosum in the course of the being pregnant is. The erythema nodosum ought to fade away inside just a few weeks. Often, that is innocent situation, however it may be an indication of underlying situation, an irregular response to an allergen or medicine or different inflammatory situations.

Erythema nodosum signs

The primary symptom of erythema nodosum is crimson and painful bump on the decrease a part of your legs. In some instances, these bumps can even seem in your face, torso, arms and thighs. These lumps may be one – half inch as much as 4 inches. You may have wherever from 2 – 50 of them. It’s bumps are painful and so they could really feel sizzling. They begin out as crimson after which, they flip into purple, wanting like bruises as they heal. Additionally, they flatten out whereas therapeutic. These bumps can final for as much as two weeks and new bumps can maintain forming as much as 6 weeks. Additionally, there may be different signs of it [4], reminiscent of

• Diarrhea
• Abdomen ache
• Weight loss
• Sore throat
• Cough
• Enlarged lymph nodes within the chest
• Ankle swelling
• Ache within the legs
• Joint ache
• Fatigue
• Fever

Most erythema nodosum sores are often:

• Shiny in look
• Various in quantity, from two to greater than fifty
• Various in dimension from a grape to a grapefruit, however principally between 1 cm and 5 cm
• A non – ulcerating or not inflicting breaks or tears within the floor of the pores and skin
• Rounded in form
• Barely raised
• Forming on the entrance of the shins, but in addition typically the ankles, knees, thighs and forearms
• On either side of the physique equally
• In colour – brilliant crimson for per week to 10 days then fade to purple or blue
• Sizzling to the touch
• Very painful

In uncommon instances, these spots could bond collectively or kind a crescent – formed ring which spreads for just a few days earlier than fading. With the right relaxation, this can resolve by itself inside 1 – 2 months, with new sores persevering with to develop or unfold all through the primary few weeks. In some instances, it will probably final for six months or extra and that is extra doubtless as a result of it’s brought on by an underlying medical situation or untreated an infection.

Erythema nodosum causes

In additional than half of all instances of erythema nodosum, the trigger for it isn’t identified. The erythema nodosum typically begins after you’ve got had an an infection or you’ve got used sure medicines. Additionally, docs imagine that the erythema nodosum may be brought on by an immune system overreaction to micro organism and different substances which you’re uncovered to. [1] The most typical causes for erythema nodosum embrace:

• In uncommon instances, most cancers [5]
• Being pregnant [2]
• Inflammatory bowel illness, ulcerative colitis or Crohn’s illness
• Coccidioidomycosis, which is an an infection of the lungs and the higher respiratory tract [6]
• Sarcoidosis, which is a situation that may trigger irritation in lots of components of your physique [7]
• Reactions to medication, reminiscent of contraception capsules, bromides, iodides, salicylates and antibiotics (sulfonamides and types of penicillin)

Most frequently, the erythema nodosum impacts folks between ages 20 – 40. It’s observed than girls have 6 occasions extra probabilities of growing erythema nodosum in comparison with males. However, the erythema nodosum can occur in folks of any age and in each sexes. [8]

References:

[1] Chowaniec M, Starba A, Wiland P. Erythema nodosum – overview of the literature. Reumatologia. 2016;54(2):79–82. doi:10.5114/reum.2016.60217

[2] Acosta A, Haver MC, Kelly B. Etiology and therapeutic administration of erythema nodosum throughout being pregnant: An replace. American Journal of Medical Dermatology. 2013;14(3). doi:10.1007/s40257-013-0024-x

[3] Golisch KB, Gottesman SP, Segal RJ. Compression stockings as an efficient remedy for erythema nodosum: Case sequence. Worldwide Journal of Ladies’s Dermatology. 2017;3(4):231–3. doi:10.1016/j.ijwd.2017.09.001

[4] Rizvi Z, Iqbal T, Javed A, Rizvi A. Erythema nodosum: A consequence of tuberculosis. Cureus. 2019;11(5):e4724. doi:10.7759/cureus.4724

[5] Xu X, Liang G, Duan M, Zhang L. Acute myeloid leukemia presenting as erythema nodosum: A case report. Medication. 2017;96(47):e8666.

[6] Chen CM, Lee HE, Li SY. Coccidioidomycosis with cutaneous manifestation of erythema nodosum in Taiwan. Dermatologica Sinica. 2010;28(4):154-8.

[7] Ungprasert P, Ryu JH, Matteson EL. Medical manifestations, analysis, and remedy of sarcoidosis. Mayo Clinic Proceedings: Improvements, High quality & Outcomes. 2019;3(3):358–75. doi:10.1016/j.mayocpiqo.2019.04.006

[8] Suter P, Mooser B, Huu Thien HPP. Erythema nodosum as a cutaneous manifestation of COVID-19 an infection. MJ Case Studies CP. 2020;13:e236613.