Erythema nodosum: Difference between revisions
No edit summary |
|||
| (11 intermediate revisions by 5 users not shown) | |||
| Line 1: | Line 1: | ||
==Background== | ==Background== | ||
{{Skin anatomy background images}} | |||
*Often marker for systemic disease | *Often marker for systemic disease | ||
*Most common in women 30-50 years of age | *Most common in women 30-50 years of age | ||
| Line 6: | Line 7: | ||
===Associated Disease Processes=== | ===Associated Disease Processes=== | ||
*Most often idiopathic | |||
*Drug induced (OCPs, sulfonamides, PCN) | *Drug induced (OCPs, sulfonamides, PCN) | ||
*[[Tuberculosis]] | *[[Tuberculosis]] | ||
*Fungal disease ( | *Fungal disease ([[Coccidioidomycosis]], [[Histoplasmosis]]) | ||
*[[Sarcoidosis]] | *[[Sarcoidosis]] | ||
*[[Ulcerative colitis]] | *[[Ulcerative colitis]] | ||
| Line 15: | Line 17: | ||
*[[Cat scratch disease]] | *[[Cat scratch disease]] | ||
*[[Mononucleosis]] | *[[Mononucleosis]] | ||
*Streptococcal [[pharyngitis]] | *Streptococcal [[pharyngitis]] (most common identifiable cause)<ref>Schwartz, R., Nervi, S. Am Fam Physician. 2007 Mar 1;75(5):695-700. https://www.aafp.org/afp/2007/0301/p695.html</ref> | ||
*Normal [[pregnancy]] | *Normal [[pregnancy]] | ||
*Malignancy (leukemia, lymphoma) | *Malignancy (leukemia, lymphoma) | ||
==Clinical Features== | ==Clinical Features== | ||
[[File:erythema nodosum.JPG| | [[File:ENlegs.jpg|thumb|Erythema nodosum in a person who had recently had streptococcal pharyngitis]] | ||
[[File:A single EN.jpg|thumb|A single lesion of erythema nodosum.]] | |||
[[File:erythema nodosum.JPG|thumb|]] | |||
*Painful | *Painful | ||
*Non-ulcerative nodules | *Non-ulcerative nodules | ||
| Line 27: | Line 31: | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
*Erysipelas | *[[Erysipelas]] | ||
*Erythema induratum (nodular vasculitis) | *Erythema induratum (nodular [[vasculitis]]) | ||
*Familial Mediterranean Fever | *Familial Mediterranean Fever | ||
*[[Insect bites]] | *[[Insect bites]] | ||
*Superficial thrombophlebitis | *[[Superficial thrombophlebitis]] | ||
*Thrombophlebitis | *Thrombophlebitis | ||
*[[Urticaria]] | *[[Urticaria]] | ||
==Evaluation== | ==Evaluation== | ||
[[File:PMC3505767 ad-24-383-g002.png|thumb|Erythema nodosum. (A) Symmetric, smooth and shiny, erythematous nodules affecting the both shins of the parient. (B) Classical appearance of septal inflammation.]] | |||
*Clinical diagnosis | |||
==Management== | ==Management== | ||
*Treat underlying cause | *Treat underlying cause | ||
*[[NSAIDs]] | *[[NSAIDs]] | ||
*Potassium Iodide | |||
*RICE, cool wet compresses | *RICE, cool wet compresses | ||
==Disposition== | ==Disposition== | ||
*Typically outpatient | |||
==References== | ==References== | ||
Latest revision as of 16:23, 11 December 2024
Background
- Often marker for systemic disease
- Most common in women 30-50 years of age
- 1:6 male to female
- Usually a self-limited disease, resolving in 3-6 wks
Associated Disease Processes
- Most often idiopathic
- Drug induced (OCPs, sulfonamides, PCN)
- Tuberculosis
- Fungal disease (Coccidioidomycosis, Histoplasmosis)
- Sarcoidosis
- Ulcerative colitis
- Crohn's disease
- Behcet's disease
- Cat scratch disease
- Mononucleosis
- Streptococcal pharyngitis (most common identifiable cause)[1]
- Normal pregnancy
- Malignancy (leukemia, lymphoma)
Clinical Features
- Painful
- Non-ulcerative nodules
- Violaceous, erythematous
- Usually anterior tibia, arms, trunk
Differential Diagnosis
- Erysipelas
- Erythema induratum (nodular vasculitis)
- Familial Mediterranean Fever
- Insect bites
- Superficial thrombophlebitis
- Thrombophlebitis
- Urticaria
Evaluation
- Clinical diagnosis
Management
- Treat underlying cause
- NSAIDs
- Potassium Iodide
- RICE, cool wet compresses
Disposition
- Typically outpatient
References
- Hebel et al. Erythema Nodosum. Apr 13, 2015. http://emedicine.medscape.com/article/1081633-overview
- ↑ Schwartz, R., Nervi, S. Am Fam Physician. 2007 Mar 1;75(5):695-700. https://www.aafp.org/afp/2007/0301/p695.html