Erythema nodosum

Overview


Plain-Language Overview

Erythema nodosum is a condition that causes painful, red bumps to appear on the skin, usually on the front of the legs. It affects the fat layer under the skin, which leads to inflammation and swelling. This condition is often a reaction to an infection, medication, or other health problems. The bumps can be tender and may feel warm to the touch. People with erythema nodosum might also experience fever, joint pain, and feeling generally unwell. It is not contagious and usually resolves on its own over several weeks. The main health impact is discomfort and sometimes difficulty walking due to the pain.

Clinical Definition

Erythema nodosum is an acute, inflammatory condition characterized by septal panniculitis without vasculitis, primarily affecting the subcutaneous fat. It is commonly triggered by a hypersensitivity reaction to various stimuli including infections (such as Streptococcus species, Mycobacterium tuberculosis), medications (e.g., sulfonamides, oral contraceptives), and systemic diseases like sarcoidosis or inflammatory bowel disease. Clinically, it presents as tender, erythematous nodules predominantly on the anterior shins. The pathophysiology involves immune complex deposition and subsequent inflammation of fat septa. It is significant as a marker of underlying systemic illness and can cause considerable pain and morbidity. Diagnosis is clinical but can be confirmed by skin biopsy showing characteristic histopathology. The condition is self-limited but may recur depending on the underlying cause.

Clinical Presentation


Diagnostic Workup


Pathophysiology


Treatments


Prevention


Outcome & Complications


Differential Diagnoses


Medical Disclaimer: The content on this site is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. If you think you may be experiencing a medical emergency, call 911 or your local emergency number immediately. Always consult a licensed healthcare professional with questions about a medical condition.

Artificial Intelligence Use: Portions of this site’s content were generated or assisted by AI and reviewed by Erik Romano, MD; however, errors or omissions may occur.

Analytics Disclosure: If you allow analytics cookies, Doctogenic uses Google Analytics, Microsoft Application Insights, and Microsoft Clarity to understand site usage, diagnose issues, review heatmaps and session replay recordings, and improve the service on pages where those tools are enabled. Clarity is not enabled on account, purchase, billing, checkout, Stripe-related, or admin pages. You can change this choice through Cookie preferences.

USMLE® is a registered trademark of the Federation of State Medical Boards (FSMB) and the National Board of Medical Examiners (NBME). Doctogenic and Roscoe & Romano are not affiliated with, sponsored by, or endorsed by the USMLE, FSMB, or NBME. Neither FSMB nor NBME has reviewed or approved this content. "USMLE Step 1" and "USMLE Step 2 CK" are used only to identify the relevant examinations.