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Erythema Nodosum

Faraz Yousefian, DO and Sujitha Yadlapati, MD Reviewed 05/2023
 


BASICS

DESCRIPTION

  • A delayed-type IV hypersensitivity reaction to various antigens, or an autoimmune reaction presenting as a panniculitis (1) that affects subcutaneous fat

  • The clinical pattern of mult...

DIAGNOSIS

HISTORY

  • Often a prodrome 1 to 3 weeks prior to the onset of lesions; can consist of malaise, fever, weight loss, cough, and arthralgia

  • Increasingly tender nodules on the legs, usually over the...

TREATMENT

  • Condition usually self-limited within 1 to 2 months

  • All medications listed as treatment for EN are off-label uses of the medications. There are no specific FDA-approved medications.

GENERAL MEASURES

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Keep legs elevated.

  • Elastic wraps or support stockings may be helpful when patients are ambulating.

Patient Monitoring

Monthly follow-up or as dictated by underlying...

REFERENCES

1
Chowaniec  M, Starba  A, Wiland  P. Erythema nodosum—review of the literature. Reumatologia.  2016;54(2):79–82. [View Abstract on OvidMedline] ...

ADDITIONAL READING

Mustin DE, Cole EF, Blalock TW, Kalangara ME, Stoff BK, Feldman RJ. Dupilumab-induced erythema nodosum. JAAD Case Rep. 2021;19:41-43. doi:10.1016/j.jdcr.2021.11.007 ...

CODES

ICD10

  • L52 Erythema nodosum

  • A18.4 Tuberculosis of skin and subcutaneous tissue

SNOMED

  • 32861005 Erythema nodosum (disorder)

  • 74610006 Tuberculous erythema nodosum (disorder)

  • 402969008 Erythema nodosum du...

CLINICAL PEARLS

  • Lesions of EN appear to be erythematous patches, but when palpated, their underlying nodularity is appreciated.

  • Evaluation for a concerning underlying etiology is necessary in EN, but m...

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