Erythema Nodosum
What is Erythema Nodosum?
Erythema Nodosum (EN) is a skin condition that is characterised by inflammation of the fat cells under the skin. Red nodules that are tender will form, and are usually seen on both sides of the shin. Within 3 to 6 weeks it will usually resolve itself, and is found most commonly in people ages 12 to 20 years of age. It is more common in woman than in men, by as much as 3 to 6 times. People with a family history of erythema nodosum and other skin conditions are at a higher risk for developing the skin condition.
What Causes Erythema Nodosum?
Causes of erythema nodosum include infections, such as Hepatitis C, cat scratch disease, Yersinia, Streptococcal infection, Mycoplasma Pneumoniae, and Tuberculosis. It can be seen in those with autoimmune disorders, such as Bechet’s Disease, Chlamydia, Syphilis, Inflammatory Bowel Disease, and Sarcoidosis. Pregnancy and oral contraceptives can also cause erythema nodosum. Certain medications, such as Penicillin, Bromides, Sulfonamides, Progestin, and hepatitis B vaccinations can also cause erythema nodosum. Cancers that have been linked to causing erythema nodosum include Non-Hodgkin disease, pancreatic cancer and carcinoid tumors. In about 30 to 50% of all cases, the cause is not determined. Ulcerative colitis, leukemia, and rheumatic fever have also been linked to this skin condition.
How do I know if I have Erythema Nodosum?
Erythema nodosum is most commonly found on the shins but can also be found elsewhere on the body, such as calves, arms, ankles, thighs and buttocks. Lesions can be found on the skin that are flat, red and hot. They are firm to the touch and are about an inch in diameter. They are painful, and after a few days of first developing them, turn to a purple. Within a few weeks, they will fade into a flat brown patch.
What are the Erythema Nodosum symptoms?
Signs of erythema nodosum include fever, joint aches, red skin that can be inflamed or irritated, general ill feeling, and swelling of the effected area. The condition will be diagnosed by a doctor just looking at the skin, however, a punch biopsy may be performed. The doctor may also order a throat culture to see if strep is present, and chest X-rays to rule out tuberculosis or sarcoidosis.
What are the available Erythema Nodosum treatments
The first step in treatment is to treat the underlying cause if there is one, such as treating strep throat. Anti-inflammatory drugs can be used and cortisone can be taken orally or topically. To reduce inflammation, Colchicine can be used. Rest will also be needed for the skin to heal. Hot or cold compresses can be used for comfort, and elevating the sore area can be helpful. A therapeutic option is using oral potassium iodine solution that is supersaturated. Do note that this option could result in hyperthyroidism, so caution must be taken when using long term.
CAM therapies (complementary and alternative therapies) can also be used to treat erythema nodosum. These are often used to reduce inflammation, prevent infections and boost the immune system. Do note that you should only use alternative therapies under the discretion of your doctor, as some may interact with medications and treatments also being provided. Vitamin C can help to protect against damage from the sun, but can also negatively impact other health conditions. Vitamin E can help to also protect against the sun, but will impact certain medications, such as blood thinners. Zinc will help to keep the skin healthy, but can interfere with antibiotics. High doses of zinc can be dangerous.
Erythema Nodosum Prevention
To prevent erythema nodosum, one should have proper hygiene. This includes washing hands often with a good anti-bacterial soap. Avoid sharing utensils, food, and drink with others as well to avoid infections. Avoiding the sun when taking certain medications can also help to prevent erythema nodosum.
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If one is pregnant, they need to use extra caution to not develop erythema nodosum. Pregnant ladies can develop fifth disease, which is a form of erythema. This virus can infect the fetus, which could cause heart failure, fetal anemia, hydrops and could result in death.
So I am assuming that erythema nodosum is contagious since it stated don’t share utensils, food or drink. And if it is related to strep and other infections then it must be somewhat contagious. My baby brother gets strep all the time, and I am going to be sure to pass this info along to my mom. He has had strep twice this year already, and he is 13 years old. I just do not want him to develop this skin condition.
From my understanding it said not to drink, eat or share utensils because the other person could be sick and you could get sick, therefore causing an immune response.
Thank you so much for this article. My husband and I are in the process of starting a family and I want to be able to take all the precautions that I can to make sure that I stay healthy before and during the pregnancy. I also never knew that pregnancy could cause erythema nodosum. How common is this for one to develop it while they are pregnant? What are the stats on it for a child being effected if the mother does have it while pregnant?
I like the idea of using vitamins for treating erythema nodosum. I never knew that vitamin C could have a negative impact on the health of one though. I guess that is why one should discuss this with their doctor first. I would have never thought that erythema nodosum would be tied to strep throat either. I have had strep many times but never got the rash with it. Is that what the rash is when people come down with strep and have the rash?
So much info here about erythema nodosum. Thanks for it all. My brother had this a few years back. He has suffered from Ulcerative colitis for several years and that was linked to him developing erythema nodosum. He has only had it the one time. He was given a shot of cortisone, and then also had a cream to apply. I remember his skin being very itchy as well and I want to say that on that he applied Calamine lotion. He also took Benadryl for the itching. I believe that the skin disorder only lasted him 3 weeks or so but that was enough for him he said. He did not like how it looked on his legs and made him very self conscious. He did not like that he had to rest up as well because it was during summer when he got it and there was so much to do outside. But one does what they have to do to make the skin heal!
I am a huge fan of using alternative medications and therapies as well. I just feel better about myself when I use them. I want to say that if you do no have a skin condition there are many things that you can apply to it. Aloe Vera gel would be amazing I feel on erythema nodosum. You can even keep it in the refrigerator to keep it cool so it is more soothing to the skin. Calendula could also be used but never apply this to an open wound as it could make it worse. Sage extract will fight inflammation, as can yarrow. I feel that when these are applied topically to the skin, they will help to heal any damage on the skin. Plus they will not damage your skin further if you use them correctly.