Erythema Nodosum is a skin disorder in which red bumps are formed under the skin causing inflammation. This type of skin inflammation occurs only in specific fatty areas and not on other parts of the skin. This causes painful reddish lumps on the affected parts and is very often found in front portion of the legs and below the knees. The lumpy nodules may grow in size anywhere from 1-5cm in length. Unlike other skin disorder, this type of nodular swelling exhibits a specific pattern thus easy to identify. The good thing about Erythema Nodosum (EN) is it will disappear on its own after few weeks, leaving only small scar on the infected area.
The exact cause of this skin inflammation is not known. Very often it is found in association with certain infectins like Chlamydia, streptococcus, Hepatitis B infection, Cat scratch disease and Syphilis, Leptospirosis and mycobacterial infection. Sometimes, if the skin becomes sensitive to certain medications like penicillin, amoxicillin or sulfonamides, the skin may develop lumps causing inflammation. Existing disorders like leukemia, rheumatic fever, ulcer and Bechet’s disease may cause Erythema Nodosum in some people.
The most prominent sign for identifying this disease is raised tender lesions or bumps on the layer of the skin, more particular in front part of the legs and below the knees. The lesions may be painful and it may turn into purple color within few days of infection and finally turns brown before fading, leaving a small patch on the affected part. Initially the lesions may be broad and raised but when it withers off from the skin it becomes flat to shrink down. In case of chronic Erythema Nodosum, there may be other symptoms like fever, redness of the skin with irritation and general ill feeling.
Since common insect bites also produces similar symptoms, it is essential to get it checked with your doctor to eliminate EN.
Your doctor may identify the disease by simply looking at the infected skin. Punch biopsy is done in case the doctor finds it difficult to confirm the disease by examining the skin layer. In some cases, the doctor may ask you to do throat culture for eliminating streptococcus infection and an X-ray of the chest to rule out TB.
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Treatment should be oriented towards identifying the underlying cause of the disease and curing it. NSAID (Non steroidal anti inflammatory drugs) are given to overcome swelling and pain. Steroids are sometimes given orally for reducing inflammation. Some of the common drugs used for treating ED are Potassium iodide and salicylate drugs. Analgesics are administered orally or by injection to reduce intense pain. Giving hot and cold compressions may help in removing discomfort associated with pain.
Normally, Erythema Nodosum stays in the skin causing painful blisters for 3-6 weeks and gradually withers off. There is no guarantee that it will not recur once you have this disease. You have chances to pick up these symptoms when you get Syphilis or Strep infection. Pregnant women are more prone to EN than other women.