Erythema nodosum (Paediatrics)

Very low urgency
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A skin lesion consisting of the appearance of nodules or painful cysts with inflammatory signs (red and hot), usually located on the leg, in the anterior part of the tibia.

In most cases, they appear as a consequence of a disease (mononucleosis, tuberculosis, streptococci, chlamydia, hepatitis B, lupus erythematosus, lymphoma, rheumatic fever, Crohn's disease) or as a reaction due to sensitivity to a drug (penicillins, oral contraceptives, sulphonamides, etc.). In other cases, the cause is unknown.

The most common symptoms are: fever, general malaise, digestive symptoms, joint and head pain, fatigue and swelling of the affected area and joints.

Diagnosis is based on a medical history and physical examination. A skin biopsy, blood test and/or x-ray may be needed.

Treatment is based on treating the underlying cause. It may also require regular antibiotics, analgesics and anti-inflammatories or corticosteroids and a potassium iodide solution. Elevating the affected limb and applying indirect local cold may help reduce inflammation. Although uncomfortable, the symptoms disappear after about 6 weeks without scarring. It is not a serious condition and recurrence is rare.

Bibliographic references
  1. J.J. Ríos, E. Sendagorta, M. J. González. Eritema nudoso. Med Clin 2009; 132(2):75-79
  2. D. Agüero, M. C. Cubero, O. Martín. Eritema nodoso, a propósito de un caso. Rev Pediatr Aten Primaria. 2009; 11(43):451-456.
  3. MedlinePlus. Rockville. 2017. Eritema nudoso; [citado el 28 de junio de 2017]. Disponible en: https://medlineplus.gov/spanish/ency/article/000881.htm
  4. UpToDate [Internet]. Waltham. 2017. Erythema nodosum; [citado el 28 de junio de 2017]. Disponible en: http://www.uptodate.com/contents/erythema-nodosum?source=search_result&search=eritema+nodoso&selectedTitle=1~71
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Symptoms

    Painful nodules below the knees


    Skin of the nodules is hot


    Tiredness / fatigue


    Fever / Feel very hot


    Skin alteration

Symptoms to watch out for

Pain that doesn't subside with analgesics
Fever that doesn't subside with antipyretics (paracetamol, ibuprofen)
History of immunodeficiency (HIV, diabetes mellitus, oncological disorders, long-term corticosteroid consumption).

Self-care

Consume over-the-counter pain relievers or anti-inflammatories.
Keep the limb raised
Relative rest, rest until symptoms subside.
Use silicone bands or compression tights.