Med. Pro Praxi 2009; 6(2): 85-89

Erythema nodosum

MUDr. Andrea Hradiská

Kožní oddělení, Uherskohradišťská nemocnice a.s

Erythema nodosum is the most common type of septal panniculitis. It may occur separately or as a part of wide range of many diseases

such as infections, sarcoidosis, inflammatory bowel diseases, malignancies, autoimmune disorders, medications, pregnancy. Erythema

nodosum is considered to be a delayed hypersensitivity response to a variety of antigenic stimuli. The incidence of erythema nodosum

is 1–5 in 100 000 population per year, with women between the ages of 15 and 40 years being most commonly affected. It is typically

presents as an acute eruption of erythematous, tender subcutaneous nodules over the pretibial areas bilaterally. The nodules subsequently

change the color from merely yellow to green, which resembles a deep bruise, the so–called erythema contusiforme. Onset of the disease

may be accompanied by fever, fatigue, malaise, arthralgia, headache or other systemic manifestations. The eruption generally lasts from

3 to 6 weeks, ulceration is never seen. The lesions heal without atrophy or scarring. Erythema nodosum is histologic example of a septal

panniculitis with no vasculitis. Treatment of erythema nodosum is influenced by underlying condition. Nodules of erythema nodosu

regress spontaneously within a few weeks, and bed rest is often sufficient treatment. Nonsteroidal anti-inflammatory drugs are used

in mild cases of a self-limited erythema nodosum. Systemic corticosteroids are rarely indicated in erythema nodosum and before these

drugs are administered an underlying infection and malignancy should be ruled out. If the erythema nodosum occurs in an association

with other diseases, we treat the underlying disease.

Keywords: erythema nodosum, aetiology, Löfgren syndrom, differential diagnosis, treatment.

Published: May 1, 2009  Show citation