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Erythema Nodosum, Pediatric

Vikash S. Oza, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

Delayed-type hypersensitivity reaction leading to inflammation of the subcutaneous fat (panniculitis) and characterized by red, tender nodules on the shins 

EPIDEMIOLOGY

  • Girls slightly...

DIAGNOSIS

HISTORY

  • A prodrome of arthralgia, fever, fatigue, malaise, or upper respiratory infection symptoms can precede skin nodules by 1 to 3 weeks.

  • Lower extremity pain and swelling is common and can...

TREATMENT

GENERAL MEASURES

Bed rest and leg elevation 

MEDICATION

First Line

Salicylates or other NSAIDs, such as ibuprofen, naproxen, or indomethacin 

Second Line

  • Potassium iodide 300 mg PO t.i.d. for 3 to...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Can expect improvement within 1 week

  • If lesions recur after cessation of treatment, an underlying infection/inflammatory should be explored.

  • If at...

ADDITIONAL READING

  • Garty BZ, Poznanski O. Erythema nodosum in Israeli children. Isr Med Assoc J.  2000;2(2):145–146. [View Abstract on OvidInsights]

  • González-Gay MA, García-Porrúa C, Pujol RM, et ...

CODES

ICD9

  • 695.2 Erythema nodosum

  • 17.1 Erythema nodosum with hypersensitivity reaction in tuberculosis, unspecified

ICD10

  • L52 Erythema nodosum

  • A18.4 Tuberculosis of skin and subcutaneous tissue

SNOMED

  • 328610...

FAQ

  • Q: What is the most common trigger for erythema nodosum in children?

  • A: β-hemolytic streptococcal infection

  • Q: Will erythema nodosum recur?

  • A: In children, the recurrence rate is 4–10% and is often a...

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