Erythema nodosum

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A skin lesion that consists of the appearance of nodules or painful cysts with inflammatory signs (red and hot), which are usually located in the frontal 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 ...). In other cases, the onset cause is not known.

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

A diagnosis is made by medical history and physical examination. Performing a skin biopsy, a blood test and/or an X-ray may be necessary.

Treatment is based on solving the cause that originated it. It may also require regular antibiotics, analgesics and anti-inflammatories or corticosteroids and a potassium iodide solution. Raising the affected limb and applying indirect local cold may help decrease inflammation.

Although symptoms are uncomfortable, they disappear after approximately 6 weeks without scarring. It is not a severe disease 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
Author
Dr. Oscar Garcia-Esquirol
Copyright
© TeckelMedical 2026

Symptoms

    Skin of the nodules is hot


    Painful nodules below the knees


    Fever / Feel very hot


    Headache


    Feeling generally unwell

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.
Relative rest, rest until symptoms subside.
Keep the limb raised
Use silicone bands or compression tights.