Erythema nodosum

Erythema nodosum – a disease of the skin and subcutaneous vessels
allergic in nature, which is manifested by dense inflamed
nodes of different sizes, mainly on the lower extremities.
The disease is diagnosed with the help of laboratory tests, examination
dermatologist, radiography of the lungs, consultation with a rheumatologist,
pulmonologist and other specialists.


  • What is erythema nodosum
  • Causes of disease
  • Symptoms of Erythema nodosum
  • Diagnosis of the disease
  • Treatment of erythema nodosum

What is erythema nodosum

Erythema nodosum or erythema nodosa is a syndrome that
manifested by allergic inflammation of the subcutaneous tissue.
Erythema nodosum belongs to the vasculitis group and is
a type of allergic vasculitis. Disease is expressed
so that painful red or
purple, most often on the legs. Erythema nodosum often
is a concomitant disease in the presence of systemic
diseases: streptococcal infections, tuberculosis and

Causes of disease

The cause of erythema nodosum is infectious
foci that are in the body. First of all, it is:


  • streptococcal foci of inflammation (streptoderma, sore throat, otitis media,
    cystitis, pharyngitis, rheumatoid arthritis, erysipelas, scarlet fever);
  • tuberculosis;
  • yersiniosis;
  • coccidiomycosis;
  • trichophytosis;
  • venereal lymphogranuloma;
  • leprosy;
  • histoplasmosis;
  • leukemia;
  • hyper nephroid cancer
  • inguinal lymphogranulomatosis.

Also, the disease occurs as a result of sensitization.
body when taking some drugs. Most dangerous in this
respect are the following pharmacological groups: salicylates,
sulfonamides, iodides, bromides, antibiotics and vaccines. Also
disease can occur due to Behcet’s disease
Crohn, with ulcerative colitis, paraproctitis, oncological
pathology. In some cases, there is a genetic
predisposition to allergic diseases and infectious

Symptoms of Erythema nodosum

The main symptom of erythema nodosum is the formation
painful nodes, accompanied by high fever and general
malaise. This is the main manifestation of Sweet syndrome (acute
dermatosis in the form of papules and brown plaques), which, in addition to
the above symptoms are characterized by neutrophilic leukocytosis,
arthralgia and other rashes polymorphic nature.

There are two forms of erythema nodosum:

  • acute;
  • chronic.

The acute form of erythema nodosum is usually accompanied by fever,
general malaise, rapidly developing painful nodes,
oval shape with fuzzy borders. Nodes are localized on
front of shins. The color of the nodes is pink first and then
the color becomes bluish. Knots resolve within 2-3
weeks, but relapses are possible.

Chronic form occurs on the background of undertreated acute
erythema nodosum. In turn, chronic erythema nodosum
There are several subspecies:

  • migrating erythema nodosum is denoted by dense nodes
    red-brown color with fuzzy borders;
  • surface infiltrative nodular erythema,
    characterized by large dense knots, the appearance of which
    accompanied by fever, swelling of the joints, a change in the formula
    blood, as well as pain.


Erythema nodosum may be an independent disease or
a symptom of another disease, or an allergic reaction to
sensitivity to any particular medication

Diagnosis of the disease

Diagnosis of erythema nodosum is based on clinical
the pictures. To establish the causes of the disease and
correctly diagnose the disease itself, you need to hold
a range of medical activities. First of all it is necessary
conduct skin tests, complete blood count. There is a change in
blood formula: leukocytosis and increased ESR (sedimentation rate
red blood cells). Also carry out the seeding of bacteriological material from
nasal discharge, if yersiniosis is suspected, baccal culture is performed,
to exclude tuberculosis – the necessary research and
consultation pulmonologist. Marked articular symptoms are
indications for rheumatological studies.

In severe cases, a biopsy is assigned to confirm the diagnosis.
nodules. Histological examination obtained
material determines the presence of an inflammatory process in small
arteries and veins, in the interlobular mediastinum at the border of the dermis and
subcutaneous tissue.

A distinction should be made between erythema nodosum and compressed erythema.
Bazena, Montgomery-OLeary-Barker knotted vasculitis, migrating
thrombophlebitis with syphilis, skin tuberculosis, subcutaneous
sarcoidosis Daria Russi and skin neoplasms.

Treatment of erythema nodosum

Treatment of the disease depends on the results of the treatment of the causative.
or concomitant disease. The rehabilitation of chronic
inflammation and relief of pain with
nonsteroidal anti-inflammatory drugs: ibuprofen,
diclofenac, nurofen. Desensitization is also conducted.
therapy. Early regression of symptoms of erythema nodosum
VLOK therapy promotes (direct blood irradiation
patient using laser beams). Extracorporeal method
hemocorrection – allows you to remove from the blood factors that provoke
disease or capable of neutralizing them.

For the relief of inflammatory factors effective local
anti-inflammatory and corticosteroid ointments and dressings with
Dimexidum. Erythema nodosum has a good effect
physiotherapy methods such as: phonophoresis,
magnetotherapy, plasmapheresis with hydrocortisone into patches
inflammatory nodes or affected joints.

In acute cases, the patient must comply with bed rest,
elevated position of the extremities, is applied to the erythemal nodes
dry warm or cool compresses.

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