Erythema nodosum is the name given to extremely tender lumps on the legs and sometimes the arms. They are caused by inflammation of the fat beneath the skin. The bumps look like bruises. They change color in the same way, from pink to blue to brown.
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Erythema nodosum is thought to be a type of allergic reaction. It may be caused by:
Streptococcal infections such as
Various viral infections such as
Bacteria, such as
Fungal lung infections such as coccidioidomycosis and
, which is also known as parrot fever
Lymphogranuloma venereum, which is an uncommon sexually transmitted diseaseLeprosy
Ulcerative colitisCrohn’s diseaseSarcoidosis
Sulfa drugs and some other antibioticsIodidesBromidesBirth control pillsLeukotriene modifiersProton pump inhibitors
This condition is rare. It is more common in females and young adults aged 20-30 years old. Having any of the causes listed above will only slightly increase your risk of the disorder.
The risk factor for erythema nodosum is genetics.
Very tender, deep lumps, like bruises,
Usually located on your shinsMay also appear on the forearms, trunk, neck, and headAssociated joint pain and fever and redness around the eyes
Your doctor will ask about your symptoms and medical history. A physical exam will be done, which may diagnose the problem based on a visual exam. You may be referred to a doctor that focuses on skin problems or infectious diseases.
Your bodily fluids may be tested. This can be done with: Blood and urine samplesCulturesPPD skin test for tuberculosisBiopsy of a lesion
Images may be taken of your bodily structures. This can be done with a
and other imaging tests.
If a cause can be identified, it will be treated. For the nodules themselves, pain relief is all that is needed. They tend to resolve on their own in about six weeks. They will not cause scarring. Treatment options include the following:
Pain relief includes: Bedrest and elevation of legsWet compressesAspirin
, except in children
This may be necessary in severe cases.
Some of the infectious causes can be avoided by practicing good hygiene, which includes: Washing your hands oftenNot sharing foods, drinks, or utensils
Erythema nodosum. Updated December 26, 2012. Accessed September 18, 2013.
Requena L, Yus ES. Erythema nodosum.
Dermatol Clin. 2008;26(4):425-438, v. Review.
Last reviewed September 2013 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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