Skip to Main Content

++

PATIENT STORY

++

A 26-year-old Caucasian woman presents for evaluation of painful, red nodules on her bilateral shins that started several days ago. The nodules were initially bright red. They are now turning darker and becoming flatter. She had a similar occurrence several months ago where she developed a bruise-like discoloration for several weeks that resolved without scarring. Her review of systems is positive for a low-grade fever, malaise, and some joint pains. Additionally, she admits to intermittent bouts of abdominal pain, as well as a few episodes of bloody diarrhea.

++

This patient was ultimately diagnosed with erythema nodosum that was found to be associated with inflammatory bowel disease. Figures 59-1 and 59-2 demonstrate characteristic erythema nodosum on the classic locations. She was prescribed rest and nonsteroidal anti-inflammatory drugs, and was referred to a gastroenterologist. After initiating treatment for Crohn disease, the nodules healed without scarring and did not recur.

++
FIGURE 59-1

Erythema nodosum in a patient with underlying Kikuchi disease. (Photograph courtesy of Matthew Zirwas, MD.)

Graphic Jump Location
++
FIGURE 59-2

Erythema nodosum in a patient with no underlying abnormality. (Photograph courtesy of Matthew Zirwas, MD.)

Graphic Jump Location
++

EPIDEMIOLOGY

++

Erythema Nodosum

++

  • The most common panniculitis that is typically seen in young women between the ages of 20 and 40. Erythema nodosum is seen 3 to 6 times more frequently in women than men. An underlying cause can be found in approximately two-thirds of cases.1

  • In children, it is most commonly associated with streptococcal pharyngitis or perianal infection.

  • In adults, it is most commonly associated with drug ingestion, sarcoidosis, or upper respiratory tract infection. Table 59-1 presents the most common associations seen in teenagers and adults.

++
Table Graphic Jump Location
TABLE 59-1.Common Associations of Erythema Nodosum and Clinical Pearls

Want remote access to your institution's subscription?

Sign in to your MyAccess profile while you are actively authenticated on this site via your institution (you will be able to verify this by looking at the top right corner of the screen - if you see your institution's name, you are authenticated). Once logged in to your MyAccess profile, you will be able to access your institution's subscription for 90 days from any location. You must be logged in while authenticated at least once every 90 days to maintain this remote access.

Ok

About MyAccess

If your institution subscribes to this resource, and you don't have a MyAccess profile, please contact your library's reference desk for information on how to gain access to this resource from off-campus.

Subscription Options

AccessCardiology Full Site: One-Year Subscription

Connect to the full suite of AccessCardiology content and resources including textbooks such as Hurst's the Heart and Cardiology Clinical Questions, a unique library of multimedia, including heart imaging, an integrated drug database, and more.

$595 USD
Buy Now

Pay Per View: Timed Access to all of AccessCardiology

24 Hour Subscription $34.95

Buy Now

48 Hour Subscription $54.95

Buy Now

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.