Erythema nodosum

Erythema nodosum is a disease from the group of deep angiitis of the skin, manifested by inflammatory nodes on the lower limbs.

The etiology is unknown.

Pathogenesis: sensitization of the vessels of the skin and subcutaneous tissue by pathogens of various infectious diseases. Usually erythema nodosum develops after or against a background of common infections (streptococcal angina, tuberculosis, leprosy, syphilis, fungal infections). Less often the sensitizer refers to medicines. Quite often erythema nodosum is a cutaneous syndrome of sarcoidosis. Sometimes it can act as a paraneoplastic symptom. Predisposing factors: colds, stagnation in the lower limbs, hypertension.

Clinical picture. Distinguish acute and chronic form. Acute erythema nodosum is manifested by the rapid eruption on the lower legs of painful bright red edematous nodes as large as a child's palm. A fever of 38-39 g is noted. C, general weakness, headache, sometimes arthralgia. The nodes completely disappear after 2-3 weeks, successively changing their coloration to cyanotic, greenish, yellow (blooming "bruise"). Ulceration of nodes does not happen. The disease is more common in young women and children, usually after suffering angina, does not recur.

Chronic erythema nodosum (nodular angiitis) is characterized by persistent recurrent course, occurs mainly in middle-aged and elderly women, often aggravated by common vascular or allergic diseases, foci of chronic infection. Exacerbations occur more often in the spring and autumn, characterized by the appearance of a small number of inflammatory dense moderately painful nodes of flesh or cyanotic pink color, the size of a puff or walnut. The main localization is the lower leg, less often the thigh. Oedemas of the lower extremities are often observed. Sometimes the nodes ulcerate. Relapses last for several months. It is necessary to differentiate from tuberculous indurative erythema (see Angiitis of the skin).

Treatment of acute erythema nodosum: bed rest, antibiotics, analgin, indometacin or brufen, warming compresses with 10% ichthyol solution, applications of 33% dimexide solution, butadiene ointment, corticosteroid ointments, "Dibunol" liniment.

Treatment and prevention of chronic erythema nodosum - see Angiitis of the skin.