Erythema nodosum is an inflammatory disease of the skin and subcutaneous tissue characterized by vivid red tumors on the skin. These changes resolve spontaneously and do not scar, but their appearance should nevertheless be a cause for concern. Erythema nodosum can indicate many diseases, including viral hepatitis, inflammatory bowel diseases or sarcoidosis. What are the causes and other symptoms of erythema nodosum? What is the treatment of this disease?
Erythema nodosum(Latin: Erythema nodosum) is an inflammation of the skin and subcutaneous tissue that presents with characteristic large, painful and red bumps on the skin. The disease most often appears between 10 and 40 years of age. and 3-6 times more often it affects women than men.
Erythema nodosum - causes and risk factors
The causes of erythema nodosum are unknown, but there are many risk factors, including:
1. Infections
- bacterial - mycobacterium tuberculosis, streptococcus (with particular emphasis on pneumococci),Yersinia(bacteria that cause zoonoses) and salmonella,
- viral - cytomegalovirus (CMV), hepatitis B (HBV) and C (HCV), Epstein-Barr virus (EBV) and HIV,
- parasitic - especially parasiteToxoplasma gondii , causing toxoplasmosis.
2. Some diseases
- sarcoidosis,
- chronic inflammatory bowel diseases (e.g. Crohn's disease and ulcerative colitis),
- connective tissue diseases (systemic lupus erythematosus, polymyositis, dermatomyositis, systemic sclerosis, vascular inflammatory diseases).
3. Taking certain medications , such as sulfonamides (antibacterial, antiparasitic and antifungal drugs), antibiotics (especially penicillin), salicylates (e.g. the popular Aspirin) and gestagens (found in oral contraceptives).
4. Some physiological conditions , e.g. pregnancy, especially at the end of the first and the beginning of the second trimester, a decrease in immunity, resulting from a long-term unhygienic lifestyle (bad eating habits, permanent stress, low sleep, fatigue).
Erythema nodosum - symptoms
Initially in the lower limbs (less frequentlyhard, painful, well-warmed, vivid red lumps, sometimes plaques appear, especially on the thighs. As the disease progresses, they change their color to brown, then green, and resolve spontaneously without leaving ulcers or scars.
The accompanying symptoms are:
- malaise, low-grade fever or fever (this is the body's response to the ongoing inflammation);
- joint pain and arthritis - develop in about 50% patients from the beginning of the disease. They can affect any joint, but most often the disease affects the ankles, knees and wrists. The inflammation goes away after a few weeks, but joint pain and stiffness may persist for several months;
- digestive system disorders, incl. abdominal pain, diarrhea,
- symptoms of inflammation of the upper respiratory tract, e.g. coughing, hoarseness,
In addition, symptoms of the underlying disease may appear, which is the cause of the development of erythema nodosum.
Erythema nodosum - diagnosis
In the case of erythema nodosum, the basic test is blood (including blood count and ESR, serological tests for the presence of viral antigens). The conclusive examination is the collection of a nodule fragment during a biopsy for histological examination.
Erythema nodosum - treatment
Erythema nodosum requires treatment of the underlying disease that is the cause of its development. If the drug is responsible for the development of erythema, it should be discontinued as soon as possible. In addition, the therapy includes local treatment - compresses from 2 percent. ichthyol solution, ichthyol ointment, methanabol and menthol ointments. The symptoms of erythema nodosum are also relieved by resting with the legs slightly elevated, and by applying pressure bandages. Over-the-counter non-steroidal anti-inflammatory drugs are also helpful. Some doctors may use the old method of administering potassium iodide. This type of therapy lasts 6-8 weeks.