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Erythema nodosum is a skin condition where red lumps form on the shins, and less
commonly the thighs and forearms. It is a type of panniculitis, i.e. an inflammatory disorder
affecting subcutaneous fat.
Erythema nodosum
Tuberculosis (TB); erythema nodosum occurs with the primary infection with TB.
TB in New Zealand is currently uncommon.
Pregnancy or the oral contraceptive pill; erythema nodosum may occur after the
first 2 or 3 cycles on the pill. EN may occur in pregnancy, clear after delivery, then
recur in subsequent pregnancies.
Other drugs; other drugs which have been reported to cause erythema nodosum
include: sulphonamides, saliclyates, other nonsteroidal anti-inflammatory drugs
(NSAIDs), bromides, iodides and gold salts.
Other causes; there are many other causes of erythema nodosum but these are
uncommon in New Zealand.
Erythema nodosum leprosum is a particular variant of erythema nodosum that affects some
people being treated for leprosy.
Fever, general aching and feeling unwell (malaise) especially when the nodules first
occur.
Joint aches or arthralgias occur in over half of those presenting with erythema
nodosum, regardless of cause. The knee jonts are almost always affected, the other
large joints less commonly. Joint symptoms may persist for months afterwards but
always resolve completely.
Throat swab
Complete blood count and C-reactive protein (CRP) and/or erythrocyte sedimentation
rate (ESR)
Virus studies
Yersinia titres
Potassium iodide has been reported to be effective but is not easy to obtain.
Oral tetracyclines have anti-inflammatory properties and may reduce discomfort and
duration of disease
Mild cases of erythema nodosum subside in 3 to 6 weeks. Cropping of new lesions may occur
within this time, especially if the patient is not resting. Sometimes, erythema nodosum may
become a chronic or persistent disorder lasting for 6 months and occasionally for years.
Related information
On DermNet NZ:
Panniculitis
Other websites: