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- $Unique_ID{BRK02162}
- $Pretitle{}
- $Title{Causes and Treatment of Erythema Nodusum}
- $Subject{Causes Treatment Erythema Nodusum tender bright-red nodules skin
- lower extremities upper bruises immunologic response tuberculosis sarcoidosis
- inflammatory bowel disease lymphoma streptococcal pharyngitis sarcoidosis
- medications birth control pills sulfonamides strep throat pharyngitis
- idiopathic fever malaise arthralgias arthritis biopsy antibiotic bed rest
- salicylates nonsteroidal anti-inflammatory agents pain rash inflammation}
- $Volume{}
- $Log{
- Anatomy of the Skin*0006701.scf}
-
- Copyright (c) 1993 Tribune Media Services, Inc.
-
-
- Causes and Treatment of Erythema Nodusum
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-
- QUESTION: I have been diagnosed with a disease called "erythema nodusum", a
- situation that I find very disturbing and a bit painful to boot. Can you tell
- me what causes the disease, and what treatments I should be taking? As of
- now, my doctor has done little but reassure me that it will all pass. I need
- to know more. Thank you.
-
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-
- ANSWER: Erythema nodosum can be the sign that alerts a physician to many
- possible diagnoses. The typical marks of erythema nodusum are extremely
- tender, bright-red nodules that seem to lie just below the skin and are spread
- symmetrically over both lower extremities, although they can also appear on
- upper extremities. As they fade, they often resemble bruises.
- Erythema nodosum is considered to be an immunologic response to a wide
- variety of conditions that may be present in the body such as tuberculosis,
- sarcoidosis, inflammatory bowel disease and lymphoma. However, the three most
- common causes of erythema nodosum are streptococcal pharyngitis, sarcoidosis
- and medications (especially birth control pills and sulfonamides), of which
- strep throat (pharyngitis) is the most likely cause in children. However, in
- a large percentage of cases, despite intensive investigations, no specific
- cause can be found. In this case it is labeled "idiopathic erythema nodosum",
- and this is the most likely diagnosis in your case.
- Many patients with erythema nodosum also suffer from fever, malaise,
- arthralgias and arthritis. The disease is diagnosed by obtaining a biopsy of
- the lesion and submitting it to a pathologist for evaluation.
- In addition, a careful history is a must, as well as a thorough physical
- examination. Laboratory testing is part of the process, and the choice of
- tests depend upon the situation in which the nodules are found and may include
- a complete blood count, chest x-ray and skin test for TB.
- When a specific cause can be determined, treatment is focused on removing
- the cause. For cases of strep throat, long term treatment with an antibiotic
- for as long as 1 year may help.
- When the underlying disease is removed, the nodules disappear as well.
- In the case of idiopathic disease, complete healing of a lesion usually occurs
- within a month or two of its appearance, even without specific therapy. And
- that is why your doctor has been reassuring you without particular
- medications. Only supportive treatment, such as bed rest, is necessary for
- some patients with erythema nodosum. Patients with extremely tender nodules
- usually require salicylates or other nonsteroidal anti-inflammatory agents to
- help relieve the pain.
-
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-
- The material contained here is "FOR INFORMATION ONLY" and should not replace
- the counsel and advice of your personal physician. Promptly consulting your
- doctor is the best path to a quick and successful resolution of any medical
- problem.
-