Erythema nodosum


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What is erythema nodosum?

is a skin condition that causes painful swollen red or purple bumps most commonly on the shins. Sometimes the bumps can also form on other parts of the body.

How common is erythema nodosum?

Erythema nodosum is the most common form of panniculitis, which is inflammation of the fat layer underneath the skin. It’s often caused by an immune response to an infection or a reaction to drugs you’ve taken. It can be managed by reducing your risk factors. Please discuss with your doctor for further information.


What are the symptoms of erythema nodosum?

The main symptoms of erythema nodosum is red, painful bumps on the lower part of your legs. Sometimes these bumps can also appear on your thighs, arms, torso, and face. The lumps can be one-half inch up to 4 inches. You may have anywhere from two to 50 of them.

Erythema nodosum bumps are painful and they may feel hot. They start out red, and then turn purple, looking like bruises as they heal. They also flatten out while healing. The bumps can last for two weeks. New bumps can keep forming for up to six weeks.

Other symptoms of erythema nodosum include:

  • Fever
  • Fatigue
  • Joint pain
  • Pain in the legs
  • Ankle swelling
  • Enlarged lymph nodes in the chest
  • Cough
  • Sore throat
  • Weight loss
  • Stomach pain
  • Diarrhea

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.



What causes erythema nodosum?

The cause is still unknown. Erythema nodosum often starts after you’ve had an infection or you’ve used certain medicines. Doctors believe it may be caused by an immune system overreaction to bacteria and other substances you’re exposed to.

Causes include:

  • Infections such as strep throat or tuberculosis
  • Reactions to drugs such as antibiotics (sulfonamides and forms of penicillin), salicylates, iodides, bromides, and birth control pills
  • Sarcoidosis, a condition that causes inflammation in many parts of the body
  • Coccidioidomycosis, an infection of the lungs and upper respiratory tract
  • Inflammatory bowel disease, ulcerative colitis or Crohn’s disease
  • Pregnancy
  • Cancer (rarely)

Erythema nodosum most often affects people ages 20 to 40. Women are six times more likely to develop it than men. However, it can happen in people of any age and in both sexes.

Risk factors

What increases my risk for erythema nodosum?

Please consult your doctor for more information.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is erythema nodosum diagnosed?

Your doctor will ask about your health history, and whether you’ve recently had an infection or used certain medicines. Then your doctor will look at the bumps.

You’ll likely get a blood test to look for signs of inflammation in your body. Blood tests can also be used to check for tuberculosis and other infections. You may have a throat culture to look for strep throat.

Other tests to look for the causes of erythema nodosum include:

  • Urine test
  • Chest X-ray
  • Stool culture

Your doctor may remove a sample of tissue from the fat layer under your skin. This test is called a biopsy. A technician at a lab will look at the sample under a microscope to check for changes related to erythema nodosum.

How is erythema nodosum treated?

If a bacterial infection caused this condition, your doctor will prescribe antibiotics to treat it. You can treat erythema nodosum that’s caused by a drug reaction by stopping the medicine.

These medicines can help you manage pain and other symptoms until the lumps heal:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve) (Don’t use these if you have Crohn’s Disease because they could trigger a flare.)
  • Potassium iodide
  • Oral steroids

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage erythema nodosum?

The following lifestyles and home remedies might help you cope with erythema nodosum:

  • Rest with your legs elevated and wear compression stockings while the bumps heal.
  • Avoid irritating the bumps by wearing itchy or tight clothing.

If you have any questions, please consult with your doctor to better understand the best solution for you.


Hello Health Group does not provide medical advice, diagnosis or treatment.


Review Date: October 16, 2017 | Last Modified: October 17, 2017

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