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Erythema nodosum: causes and treatment methods. Erythema nodosum Erythema nodosum

(on the Internet you can find the name “erythema nodosum or erythema nodosum”) is an inflammatory disease characterized by damage to small vessels in the dermis and subcutaneous fat. Manifests itself in the form of dense painful nodes. The term “erythema nodosum” was introduced by the British scientist R. Willan. You can get erythema nodosum at any age, but young patients and women are more likely to be affected by this pathology. It has been observed that children suffer from this disease more severely.

Causes of erythema nodosum (nodosum) on the legs

The disease can occur independently (idiopathic erythema nodosum), but is often a concomitant syndrome accompanying any underlying disease. It occurs in the following diseases:

tuberculosis
sarcoidosis
lymphogranulomatosis
leukemia
some sexually transmitted diseases
streptococcal infections (streptoderma, tonsillitis, scarlet fever, etc.)
fungal diseases (histoplasmosis, coccidioidomycosis)
oncological diseases
leprosy
nonspecific ulcerative colitis

Sometimes erythema nodosum on the legs can appear as a reaction of the body to certain medications: sulfonamides, antibiotics, contraceptives, iodine and others.

The risk of erythema nodosum of the lower extremities may increase during pregnancy. Some role in the appearance of this pathology is played by hereditary predisposition.

The following individuals are often affected by the chronic course of the disease:

having vascular diseases
with foci of chronic infections (pyelonephritis, tonsillitis, sinusitis, etc.)
with diseases of allergic origin

Is erythema nodosum contagious?

Erythema nodosum itself is not a contagious disease. However, if the cause of its appearance was, for example, an infection, then it can become dangerous to others. But it is not necessary that the infected person will also develop erythema nodosum of the lower extremities.

Symptoms

Depending on the nature of the course, the severity of the symptoms of erythema nodosum and the duration of its appearance, three types are distinguished. The symptoms of each type of pathology are slightly different.

Acute erythema nodosum

On the surface of the feet, legs, sometimes thighs and, less commonly, forearms, painful, swollen, dense nodes appear without clearly defined boundaries, which reach the size of a large walnut. They are located symmetrically on both limbs. The nodes rise slightly above healthy areas, the skin above them is bright red. Over time, the color changes: from purple-violet to yellowish-green, which resembles a “blooming bruise.” The nodes do not merge and never ulcerate.

They go away within three to six weeks. There are never any scars or traces of atrophy left at the site of their localization. There are no relapses of the disease.

Acute erythema nodosum is also accompanied by the following symptoms:

general weakness
temperature rise to 39 degrees
muscle and joint pain
leukocytosis
increase in ESR

The acute form usually affects young women, children or adolescents.

Migratory type of erythema nodosum

Characterized by a subacute course. It begins with the appearance of a single node on the lower leg - flat, dense and delimited from other tissues. The skin over the node is bluish-red. Next, the node transforms into a ring-shaped plaque with a pale, sunken center. It is also possible that several small nodules may appear on both legs.

This form is accompanied by:

low-grade fever (about 37.5 degrees, but for a long time)
general deterioration of condition
chills
arthralgia

The duration of erythema nodosum can last up to several months.

Chronic type of erythema nodosum.

The course of the disease is chronic with spring-autumn seasonal exacerbations. The nodes are weakly expressed - they do not rise and do not change skin color, and can only be detected by palpation. As a rule, they are localized on the legs in their anterolateral part. Chronic erythema nodosum has a protracted course - some nodes resolve, others appear to replace them.

Typically, elderly and middle-aged women who have any inflammatory diseases, tumors or foci of chronic infections are susceptible to pathology.

Why is erythema nodosum of the lower extremities dangerous and its consequences?

The prognosis for erythema nodosum is generally favorable. The disease is not life-threatening and is highly treatable; relapses do not occur very often. There are no aesthetic problems either - the nodes pass without leaving any traces. However, it is worth remembering that this pathology is not always independent. If erythema nodosum is a symptom of some other, possibly more serious disease, then it is necessary to spend time on a thorough examination and correct diagnosis. Obviously, in this case, success will be largely determined by the effectiveness of treatment of the underlying disease. About treatment methods for erythema nodosum on the legs

Alexander Medvedev, head of the Center for the Treatment of Skin Diseases at the European Clinic “Siena-Med”, will talk about erythema nodosum and methods of treatment:

Erythema nodosum is a disease in which inflammation of the vessels of the epidermis and fatty tissue occurs. Photos of patients who develop this pathology show characteristic external signs of erythema nodosum - they are difficult to confuse with other skin diseases. Women aged 15-30 years suffer most from this disease. It affects them 3 times more often than men. Before we reveal the causes of this disease and the principles of its treatment, let's first talk about the forms of the disease that occur?

Varieties (types) of disease, classification

There are several types of erythema nodosum, the treatment of which is slightly different. From photographs of patients with various inflammatory formations, it is difficult for a non-specialist to determine what is the difference between one type of pathology and another.

The following types of erythema nodosum are distinguished:

Toxic, which affects newborns. It is considered a physiological norm and disappears in 7-10 days.
Infectious, developing against the background of various infections in adults and children.
Migratory, which may be a symptom of Lyme disease. The rash in this form is ring-shaped with a pale center and is located at the site of the tick bite.
Multiform exudative, developing against the background of colds. It is accompanied by malaise, pain in the throat and joints. Nodules form on the feet, hands, legs, oral mucosa and genitals.
Ring-shaped, appearing in the chronic form of the disease. It occurs when the body is poisoned, infectious diseases and allergies. With it, rounded nodules often merge into rings.

Causes, factors of occurrence, methods of spread of the disease

Most often, erythema nodosum is a sign of some other serious disease. The causes of this pathology are different:

Infectious (streptococcal lesions in the form or, mite, coccidiodosis, lymphogranuloma, histoplasmosis, systemic lupus erythematosus), which are characterized by the occurrence of chronic foci of infections.
Non-infectious (ulcerative colitis, rheumatoid arthritis, sarcoidosis, tumors, Crohn's disease).
With an allergic nature (taking sulfur-containing drugs, using oral contraceptives).

In some cases, this disease occurs during pregnancy. The provoking factor in its development is the pathological state of the blood vessels during thrombophlebitis.

Signs and symptoms of erythema nodosum

This disease can manifest itself in different forms:

Acute, which is characterized by a deterioration in a person’s general health, high fever, loss of appetite, and the appearance of specific nodes that have a red tint. These nodes are painful on palpation. Over time, they turn purple and then brownish-yellow. Nodes can appear on the skin of the lower extremities, namely the legs, knees, thighs, buttocks, and less often on the neck and face. Erythema nodosum in its acute form is in some cases accompanied by inflammation of the joints. Often this form of the disease goes away on its own after 6-7 weeks.
Chronic, in which external manifestations of pathology sometimes disappear for a while and then reappear. With it, erythema nodes often merge, forming extensive skin lesions. Erythema nodosum on the legs in this form is characterized by the appearance of lesions of the epidermis in new places after the old ones have already passed. In this case, the so-called “migration” of erythema nodes is observed. This form of pathology can last for months. It is often accompanied by arthropathy without vascular deformation.

Main symptoms of the disease:

Dense nodules in the tissues of the dermis and subcutaneous tissue, 1-5 cm in size. They have unclear outlines and at the same time rise slightly above the epidermis. The tissues around them swell and the skin thickens. It has a reddish smooth surface.
Nodes appear symmetrically on the front surface of the legs. In some cases, unilateral rashes are observed. They grow quickly, but at a certain point they stop growing.
Erythema does not itch, but hurts when palpated or spontaneously.
Swelling of the small joints of the feet and hands.
Compaction of nodes on the 4th-5th day of the disease.
Change in skin color on the erythema is similar to a hematoma.

After 2-3 weeks from the onset of the disease, its symptoms begin to subside. Without treatment, the disease can become chronic with relapses. In this case, with repeated outbreaks, erythema is isolated. They are distinguished by their density and bluish tint.

Complications of the disease, why the disease is dangerous

Erythema nodosum is a disease that is dangerous due to its possible complications. Its acute phase often turns into a chronic phase, the treatment of which is characterized by its complexity. That is why one cannot hope that such a pathology can disappear without a trace on its own or through the use of traditional medicine recipes. Photos of patients chronically suffering from this disease are simply shocking with terrifying skin lesions not only of the lower extremities, but also of other parts of the body. Only an experienced doctor who has established the correct diagnosis and prescribed the correct treatment will help get rid of it.

Diagnostics

Although this disease has characteristic symptoms and signs, only a doctor can confirm the diagnosis. In this case, the patient needs to visit not only a dermatologist. He may need to consult a rheumatologist, therapist and other specialists who will determine the causes of this pathology and prescribe adequate treatment.

Erythema nodosum is most often diagnosed immediately upon examination. The patient takes a throat swab, which is tested for streptococcus. It is also necessary to take an x-ray of the lungs to rule out causes of the disease such as tuberculosis and sarcoidosis. Sometimes, to confirm the diagnosis, the patient submits stool, which is examined for the presence of Yersinia pathogens.

This erythema disease is characterized by an increased erythrocyte sedimentation rate. Its characteristic feature is that in some cases it is not possible to determine the underlying disease that led to the pathology. In this case, erythema nodosum is considered an independent disease.

An important point is differential diagnosis, which allows one to exclude diseases such as vasculitis.

Treatment of erythema nodosum

Treatment of this pathology directly depends on the causes that caused it. The doctor prescribes therapy only after the patient has undergone a complete diagnosis. This is best done in a hospital setting. In acute cases, semi-bed rest is prescribed.

Treatment is carried out using various medications. These include:

such as Nimesil.
Antihistamines (Diazolin, Claritin, Telfast).
Hormonal drugs (Prednisolone), which are used for allergies, but are not prescribed in case of infectious lesions of the lower extremities.
Potassium iodide (in the absence of contraindications).
, which are effective in the presence of infection.
b, which is used for local treatment.

Physiotherapeutic procedures give good results: warm compresses with ichthyol, phonophoresis, UHF, diathermy. After suffering from the disease, the patient is not recommended to undergo various physical activities for a month.

Treatment with folk remedies

Medication therapy complements treatment with folk remedies well. Before using them, you must always consult with your doctor so as not to aggravate the situation by taking contraindicated substances. Such treatment cannot completely replace the use of medications. Various food products are used as anti-erythema agents, which must be included in the patient’s diet. These include: beans, beans, dill, basil, caraway seeds.

Erythema nodosum of the lower extremities is often accompanied by edema. In this case, the doctor prescribes various diuretic herbal mixtures.

Important: Treatment with folk remedies in no way relieves the patient of erythema nodosum, but can significantly alleviate his condition.

Diet, nutrition

With this disease, exclude any foods that can cause allergic reactions in a person. The consumption of fried, canned and smoked foods is also not allowed. The patient is transferred to a dairy-vegetable diet.

Features in children

Erythema nodosum in children is much more severe than in adult patients, and therefore requires immediate treatment.

Features of erythema nodosum in pregnant women

Not only a dermatologist treats this pathology during pregnancy. Therapy is started after examination by an obstetrician-gynecologist and other specialists to identify possible causes of the disease. Erythema nodosum harms a woman's health, but has little effect on the fetus. A pregnant woman may experience various complications in the functioning of the cardiovascular system. Sometimes this pathology goes away on its own after the 2nd-3rd trimester. In this case, it is associated with the woman’s body’s reaction to pregnancy. To treat erythema nodosum in pregnant women, Indovazin or Curantil is used topically. Parcetamol can be prescribed in small doses.

How to distinguish vasculitis from erythema nodosum

Some inexperienced people confuse erythema nodosum with a serious disease such as vasculitis. Although they have some similarities, they are very different from each other. Vasculitis is a whole group of pathologies accompanied by inflammation of the walls of blood vessels, which leads to the death of their tissue. Depending on the type of affected vessels, these diseases are divided into the following groups: arteritis, arteriolitis, capillaritis, phlebitis. It can result in Kawasaki, Takayasu, Behcet's diseases, hemorrhagic or mixed, allergic vasculitis, Wegener's granulomatosis, nonspecific aortoarteritis, Churg-Strauss syndrome.

Vasculitis has a characteristic feature: slight bleeding on the skin. They then spread to the joints, nerve endings and muscles.

Erythema nodosum is a disease in which inflammation of the subcutaneous fatty tissue and blood vessels of the skin occurs. It is very common, erythema nodosum occurs especially often during pregnancy.

Symptoms of erythema nodosum

A symptom of erythema nodosum is the appearance of nodules with a diameter of 1 to 3 cm. They often appear on the legs, but can also appear in the thighs, buttocks and arms. As a rule, the appearance of nodules is symmetrical on both limbs. The nodules have a shiny, thin and hot surface, are located just above the surface of the skin and are painful when pressed.

Precursors to the appearance of a rash with erythema nodosum are aching sensations in the joints, a state of general malaise and fever, similar to flu-like conditions.

Causes of erythema nodosum

There are many causes of erythema nodosum and they are quite different. The most common are tuberculosis, streptococcal infections and sarcoidosis. Other main causes of erythema nodosum:

Infectious:

Non-infectious:

Erythema nodosum can occur from the use of salicylates, iodides, bromides, sulfonamides, antibiotics and other drugs, especially from the use of contraceptives and contraceptives. Also susceptible are those people who have varicose veins and thrombophlebitis. These factors explain why pregnant women are highly susceptible to erythema nodosum.

Often, erythema nodosum can be an independent disease. In such cases, it is impossible to determine the cause.

Forms of the disease

The acute form is characterized by an increase in body temperature to 39°C, the appearance of chills, pain in the joints, neck, hips and shoulders. Lumps appear under the skin without clear boundaries. The bright red spots that appear at first disappear within a month.

Subtypes of the chronic form are allergic vasculitis and Beverstedt's vagus erythema. Allergic vasculitis is characterized by a small number of nodules that do not go away and, accordingly, do not change their color. It lasts a very long time, and relapses often occur. With Beverstedt's wandering erythema, nodules appear and fade, and new lesions appear around the perimeter that do not change their color.

Treatment of erythema nodosum

In order to determine the causes and prescribe treatment for erythema nodosum, you need to consult a dermatologist. The doctor will make a diagnosis during a visual examination. During the initial visit, a throat swab is taken to detect streptococcus and stool for Yersinia, and an X-ray of the lungs is taken to rule out sarcoidosis and tuberculosis.

Erythema nodosum rash is usually treated with corticosteroids. But they are not used if there are infectious diseases.

Erythema nodosum is mainly treated with salicylates and a wide range of antihistamines: diazolin, suprastin, Zyrtec, Tavegil, Telfast, Claritin. Sometimes antibiotics are also prescribed. Self-medication or the use of antibiotics on your own is strictly prohibited, as this can cause allergic manifestations and complications in the gastrointestinal tract.

Bed rest is required. Physiotherapy is also used for treatment - warming ichthyol compresses, phonophoresis, UHF, warm compresses on the lower leg, diathermy. After local symptoms are cured, immunostrengthening therapy is carried out.

Erythema nodosum during pregnancy

If a pregnant woman develops erythema nodosum, doctors immediately conduct a diagnosis to identify the cause. This is very important because if the cause is a serious illness such as tuberculosis, Behçet's disease or gastrointestinal diseases, treatment will be much more difficult.

Erythema nodosum has virtually no effect on the baby in the womb. It is more harmful for the mother herself, as it can cause cardiac complications. There are also cases when the disease goes away on its own by the end of the II-III trimester.

In the absence of complications, local treatment is carried out: indovazine is used to lubricate the lesions, chimes and paracetamol are prescribed orally in small quantities. Inflammatory phenomena are relieved with aspirin in small doses, diclofenac is injected.

During treatment of erythema nodosum during pregnancy, it is important to adhere to proper rest and sleep patterns. It is also important to determine the load on the vessels in the lower extremities: it should be minimal, but at the same time it should maintain the vessels in good shape. Depending on the severity of the disease, the doctor will prescribe either alternating physical activity with rest, or bed rest. It is very important to choose the right treatment, otherwise, even after childbirth, erythema nodosum may not go away, but take a chronic form, in which it will constantly worsen in spring and autumn, as well as during unfavorable conditions (stress, climate change, infectious diseases) or the next pregnancy.

Video from YouTube on the topic of the article:

Erythema nodosum is a disease in which there is damage to the skin and subcutaneous vessels of an inflammatory nature. This disease is of an allergic nature. During its development, the patient develops dense hemispherical painful nodes. They can vary in size and most often appear symmetrically on the lower extremities.

For the first time the term " erythema nodosum» introduced by a dermatologist from the UK Robert Willan V 1807. Later studies made it possible to conclude that erythema nodosum is one of the variants of a allergic vasculitis . If we compare the symptoms of the disease with systemic vasculitis , then with erythema nodosum there is local vascular damage, which mainly appears on the legs.

The disease can manifest itself in patients at any age, but most often the disease affects people in the age group from 20 to 30 years. If before puberty erythema nodosum is distributed equally among both sexes, then after this period erythema nodosum occurs in women in 3-6 times more often. The number of cases of the disease increases in winter and spring.

Types of erythema

In order for the treatment of erythema to be as effective as possible, the type of erythema must be determined during the diagnostic process. There are several different types of this disease. Erythema toxicum appears in newborns and is a physiological norm. The child develops skin rashes. No other symptoms are observed. This is a natural manifestation that disappears on its own about a week after its appearance.

Erythema infectiosum occurs in a person suffering from acute infectious diseases of unknown etiology. It appears in both adults and children.

Erythema multiforme exudative , as a rule, develops with colds. Characteristic symptoms of the disease are severe headache, general malaise and weakness, pain in the joints and throat, rashes that mainly appear on the skin of the hands and feet, as well as on the palms, legs, genitals, and oral mucosa. Pronounced rashes can be distinguished even in the photo. These are reddish spots with clear boundaries, which sometimes become vesicles with serous contents, which open on their own, leaving bleeding erosions. If the disease is not treated, death can occur.

Erythema migrans - this is a characteristic symptom Lyme disease , which is transmitted through a tick bite. A ring-shaped erythema appears around the place where the tick has attached itself, which increases very quickly and at the same time turns pale in the center.

Ring-shaped erythema - chronic illness. The reasons for its manifestation are poisoning of the body, infectious diseases, and allergic reactions. It is characterized by the appearance of spots that have a rounded shape. These spots merge into rings. More often the disease develops in young men.

There are also other types of erythema that appear in certain pathologies and diseases.

Causes of erythema nodosum

Erythema nodosum develops in the human body due to the manifestation of infectious processes. First of all, we are talking about streptococcal infections . Consequently, the disease develops with other diseases. Symptoms of erythema nodosum also appear in patients. Less commonly, the disease develops when trichophytosis , coccidioidomycosis , inguinal lymphogranulomatosis . In addition, the cause of the disease can be drug sensitization due to taking sulfonamides , salicylates , iodides , bromides , antibiotics , and also as a consequence vaccinations .

Often acute erythema nodosum in children and adults appears with. Non-infectious reasons for the development of the disease are Behçet's disease , inflammatory bowel diseases , ulcerative colitis , oncological diseases . But in these cases, symptoms of the disease appear less frequently. Erythema nodosum can also occur when there are foci of chronic infection in the body. Sometimes erythema nodosum is diagnosed in several members of the family, that is, we can talk about a hereditary tendency to erythema nodosum. People who have vascular disorders and a tendency to allergic diseases are prone to a chronic course of the disease.

It is very important that the disease is diagnosed in a timely and efficient manner. When determining how to treat erythema nodosum, the doctor must find out what exactly was its root cause. But in any case, treatment of erythema nodosum is always carried out only under the supervision of a specialist.

Symptoms

The main manifestation of this disease is the presence of dense nodes, which are located in the lower parts of the dermis or in the subcutaneous tissue. Such nodes can have different diameters: it varies from 5 mm to 5 cm. The skin above the nodes is red and smooth. The nodes rise slightly above the general skin, but no clear boundaries are observed, since the tissue around them swells. Such nodes grow very quickly, but once they reach a certain size, they stop growing.

People with erythema nodosum experience different types of pain. It can manifest itself both during palpation and from time to time occur spontaneously. There is no itching in the affected areas.

After about 3-5 days, the nodes resolve. They compact and do not fall apart. A characteristic symptom is a change in skin color in the areas above the nodes. This process is similar to how it goes gradually. At first the skin becomes brownish, and then turns blue, and gradually turns yellow.

Most often, nodes with erythema nodosum appear on the anterior surface of the legs. In most cases, the lesion is symmetrical, but sometimes unilateral or single rashes are observed. In all places of the body where subcutaneous fatty tissue is located, elements of erythema nodosum may appear. They appear on the calves, thighs, buttocks, face, and sometimes on the episclera of the eyeball.

Most often, erythema nodosum begins acutely. The person experiences fever, chills, weakness, and lack of appetite.

Most patients with erythema nodosum experience arthropathy : worried about pain in the joints, morning stiffness, pain when palpating. About a third of patients experience symptoms of an inflammatory process in the joint (). The skin in the joint area turns red and swells, and intra-articular effusion is observed. In the presence of articular syndrome in patients with erythema nodosum, large joints are affected symmetrically. Small joints of the hands and feet may swell. General symptoms and arthropathy sometimes appear several days earlier than the elements on the skin.

Depending on the severity of the disease, the nodes completely resolve within two to three weeks. At the place where they were located, hyperpigmentation may be observed for some time. When the skin manifestations disappear, the articular syndrome also disappears. The acute period of the disease lasts for about one month.

A chronic course of the disease with periodic relapses is observed in more rare cases. During exacerbations, a small number of nodes appear. As a rule, the nodes are single, they are dense, bluish-pink and can persist for several months. Sometimes manifestations on the skin are accompanied by chronic arthropathy, but the joints are not deformed.

Diagnostics

During the diagnostic process, the doctor initially examines the patient. Laboratory tests are required. However, it should be noted that changes in the data of such studies are non-specific. But still, with their help, it is possible to differentiate the disease, as well as determine the cause and concomitant disease. The result of a clinical blood test in acute form of erythema nodosum or in case of relapse of a chronic disease shows an increased ESR And neutrophilic leukocytosis . To determine the presence of streptococcal infection in the body, a bacterial culture is performed from the nasopharynx. If the doctor suspects yersiniosis, the doctor will prescribe a stool culture. To exclude tuberculosis, tuberculin diagnostics is performed. If the patient complains of severe articular syndrome, consultation with a rheumatologist and subsequent blood testing for rheumatoid factor is necessary.

If there are difficulties in confirming the diagnosis, it is possible to perform a biopsy of one of the nodes. During histological examination, an inflammatory process can be detected.

To determine the origin of the disease, the presence of vascular disorders, foci of chronic infection, the patient needs to consult with an infectious disease specialist, pulmonologist, otolaryngologist and other specialists. Also, if necessary, during the diagnostic process, rhinoscopy , pharyngoscopy , radiography And CT lungs , vein examination , Rheovasography of the lower extremities and etc.

Lung examination reveals tuberculosis , sarcoidosis or other pathological processes in the lungs.

Treatment

Whether therapy for erythema nodosum will be effective directly depends on how adequate the treatment of the underlying disease or pathology is. It is necessary to sanitize chronic foci of infection; if necessary, antibiotic treatment and desensitizing treatment are prescribed. It is also recommended to take vitamins C, P, and calcium chloride. To stop the inflammatory process and prevent pain, patients with erythema nodosum are prescribed non-steroidal anti-inflammatory drugs. This and other medications. Methods of extracorporeal hemocorrection are also used, and laser irradiation of blood is practiced. All these methods contribute to a faster fading of the symptoms of erythema nodosum.

Local use of corticosteroid and anti-inflammatory ointments is also practiced. If there is inflammation in the joints, then bandages with. Patients with erythema nodosum are also prescribed physiotherapeutic treatment methods. Effective in the treatment of erythema nodosum, ultraviolet radiation, magnetic therapy, phonophoresis with hydrocortisone at the site of inflamed nodes, laser therapy. But it is most difficult to treat erythema nodosum during pregnancy, since at this time the use of many medications is contraindicated. In this case, strict supervision of a specialist is necessary.

Erythema nodosum is a disease characterized by inflammation of the blood vessels of the skin and subcutaneous fat. Most often occurs in women (three times more often than men), aged 15 to 30 years. The causes of this pathology are very diverse and incompatible with each other.

Causes of erythema nodosum

These are various infectious causes: streptococcal infections (tonsillitis, scarlet fever), tuberculosis, yersiniosis, lymphogranuloma venereum, leprosy, histoplasmosis, coccidiosis. In a word, all that we call “chronic foci of infections.”

It is also necessary to note the allergic nature of erythema, which most often occurs when taking sulfonamide drugs (sulfalene, sulfodimethoxine) and contraceptives.

There are acute and chronic forms of the disease. The acute form is characterized by a deterioration in the general condition, an increase in temperature, the appearance on the legs, knees, less often the face, neck, painful on palpation, having a red color, changing to purple, then brown and yellowish. Half of the patients have inflammation of the joints. Erythema nodosum occurs more severely in children. The process resolves on its own after 6-7 weeks.

Symptoms of erythema nodosum on the skin

In a chronic course, this condition does not go away for long; the nodes tend to merge or appear in new places after resolution in old ones, that is, they migrate.

Diagnosis of erythema nodosum

To establish the causes and treatment, you must contact a dermatologist, rheumatologist, general practitioner, or your attending physician if the cause is known (tuberculosis - phthisiosis, sarcoidosis - pulmonologist, etc.).

Not only do you make the correct diagnosis for yourself and not confuse erythema, for example, with skin tuberculosis, but you also need to understand the reasons, which can be very serious. The statement of old clinicians applies to this disease: “The skin is a barometer of the internal environment of the body.”

The diagnosis of erythema nodosum is made by visual examination. At the first visit, it is advisable to take a swab from the oropharynx for streptococcus and take an x-ray of the lungs to exclude sarcoidosis and tuberculosis, as well as give stool for Yersinia.

Treatment of erythema nodosum

Treatment is prescribed depending on the causes. I would advise the patient to go to the hospital and undergo a head-to-toe examination. In most cases, this condition is unlikely to allow you to fully perform work, even one not related to physical labor. So a sick leave is still necessary.

For the treatment of erythema nodosum, the following groups of drugs are used: non-steroidal anti-inflammatory drugs (nimesil, indomethacin), hormones (prednisolone), which should not be taken in case of infectious processes, but in case of allergies it will come in handy, potassium iodide orally (if there are no contraindications), antibiotics for infectious process. Local treatment (heparin ointment).

Folk remedies are used together with the main treatment. Some grains and herbs are added to the diet: green beans, beans, basil, dill, cumin. For edema, diuretics are used.

But we must remember that they will not identify or cure the root cause, they are only a “thread” for the successful resolution of the process and alleviation of the condition.

Until the acute stage of the disease disappears, semi-bed rest must be observed. Milk-vegetable diet. After suffering from erythema nodosum, physical activity should be avoided for at least 1 month.

To summarize, we can say that treating erythema is an art, subject only to specialist doctors, and even then not to everyone.

Complications of erythema nodosum

The danger of acute erythema nodosum lies in its transition to a chronic course. Therefore, I would like to protect the most courageous gentlemen from complacency that everything will be resolved by itself in 6-7 weeks, which I spoke about above and about which so much is written in educational literature. It is necessary to undergo treatment.

And, of course, no one has canceled the mass of complications that lead to all those serious diseases that the skin signals to us by the appearance of erythema nodosum.

Consultation with a doctor regarding erythema nodosum:

Question: I recently suffered from erythema nodosum, spent 2 weeks in the hospital, was completely examined, and the cause was never found. Does this mean that I was poorly examined? There were no more relapses.
Answer: No. Still, in some cases the cause is not identified, but if, God forbid, there are repeated relapses, I recommend that you undergo a re-examination.

Question: Please advise which department is best to undergo the examination?
Answer: If the cause has not been identified, then start with therapeutic or dermatological treatment. There, if necessary, you will be given a consultation with the required specialist. Now there are such services as “examination in 3 - 5 days”.

Question: So what is the main prevention of erythema nodosum?
Answer: Sanitation of chronic lesions and chronic diseases, healthy lifestyle, hardening.

Dermatologist Mansurov A.S.