Dr. M.J. Bazos, MD
Patient Handout
ERYTHEMA
NODOSUM
About Your
Diagnosis
Erythema nodosum (EN) is a rash that occurs in a
number of different conditions. It almost always occurs on the front of the
lower legs (over the shin bones) but can also occur in other places. Erythema
nodosum is more common in women than men. Although anyone can get EN, it usually
occurs in individuals in their 20s and 30s. Erythema nodosum is caused by
inflammation of the fat under the skin. The most common causes of EN are certain
medications (in particular, birth control pills and “sulfa”
medicines) and infections. Sarcoidosis, ulcerative colitis, Crohn’s
disease, thyroid conditions, lupus, and pregnancy can also cause EN. In many
individuals the cause of EN is not known. Erythema nodosum is usually diagnosed
by the typical way it looks. However, a skin biopsy specimen is sometimes needed
to make the diagnosis. A medical history, physical examination, chest X-ray, and
certain blood tests may help determine whether there is a specific
cause.
Living With Your
Diagnosis
Erythema nodosum causes
painful, bright-red nodules (or bumps) under the skin. It usually occurs on both
legs. Sometimes individuals have fevers, chills, fatigue, and joint pain before
the rash
begins.
Treatment
Treatment
of the condition causing erythema nodosum usually will help improve the rash.
Otherwise, it usually improves on its own in about 6 weeks. If your doctor
believes the EN is from a medication, it will be necessary to stop that drug.
Nonsteroidal anti-inflammatory drugs (NSAIDs) may help reduce the pain and
inflammation of EN. Occasionally, a more potent anti-inflammatory medicine such
as prednisone, a cortisone-like medicine, is necessary. Potential side effects
of NSAIDs include stomach upset, ulcers, constipation, diarrhea, headaches,
dizziness, difficulty hearing, and skin rash. Potential side effects of
cortisone-like medicines are increased appetite, weight gain, difficulty
sleeping, easy bruising, and stomach
upset.
The
DOs
• Take your medicines as
prescribed.
• Follow your
doctor’s treatment
instructions.
• Ask your doctor which
over-the-counter medications you may take with your prescription
medications.
The
DON’Ts
• Don't wait to see
if side effects from medications will go
away.
When to Call Your
Doctor
• You experience any
medication side effects.
• The
treatment is not decreasing your symptoms in a reasonable amount of
time.
• You develop new, unexplained
symptoms.