Erythema Nodosum - Symptoms

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What are the signs and symptoms of erythema nodosum?

Characteristic features of erythema nodosum included raised, tender, reddish nodules, most commonly below the knees in the front of the legs. They are typically painful and can slowly come and go.

There are several scenarios for the outcome of erythema nodosum. Typically, these areas of nodular tenderness range in size from about a dime to a quarter and they may be tender and inflamed off and on for a period of weeks. They usually then resolve spontaneously, each one of the little areas of inflammation shrinking down and then becoming flat rather than raised and inflamed. They leave a bruised appearance. Then, they resolve completely on their own. Other lesions can sometimes pop up elsewhere. This may occur for periods of weeks to months, and then they eventually go away. However, chronic erythema nodosum that may last for years is another pattern. Chronic erythema nodosum, with intermittent recurrences, can occur with or without an underlying disease present.

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Comment from: DEM867, 35-44 Female (Patient) Published: December 18

I was diagnosed with erythema nodosum (EN) in the summer of 2011. It started in July with feeling feverish everyday around midday. Shortly after the first symptom a red bump appeared and I thought it was an insect bite, however it got harder and bigger. Other nodules soon began to appear all on the lower half of my legs, also under my big toenails, which looked like a blood clot. By mid-August my legs were getting stiffer and stiffer, along with the bottom of my feet. My menstrual cycle changed from red to all brown and since Sept 2011, has remained at 2 days. The doctor subscribed prednisone and said that it would run its course. The stiffness in my legs quickly went away. It took about 6 months for things to return to normal, especially the color of my menstrual cycle. All tests came back negative, except a vaginal bacterial infection, so I often wonder if that was the cause or it was the antibiotics that was initially prescribed to me in July by the first doctor who did not properly diagnose the illness.

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Comment from: Zweifel78, 35-44 Female (Patient) Published: January 09

I first came down with a bad case of strep. By the end I had gone to the urgent care, hospital and had 3 rounds of antibiotics, plus a few steroid shots to get rid of it. It was awful. Several weeks later I got a large swollen bump on the knuckle of my right hand. The urgent care said spider bite even though I disagreed. My whole body ached and I was having trouble moving and walking. I even went to a chiropractor with no luck. Then the nodules started showing up on my legs. My doctors were stumped at first, but finally diagnosed me with erythema nodosum and referred me to a rheumatologist. The first specialist I saw gave me prednisone for the symptoms and was kind of done with me. Months later I got strep again. I went to the doctor immediately to start on antibiotics. They prescribed the Z-Pak as they usually do (I'm allergic to penicillin). That didn't work and I was back in there within 2 days. When I have gotten strep these past 2 times, it takes me down for a week. I mean, can't get out of bed and I need help going to the restroom. And it takes 2 to 3 rounds of antibiotics to cure it. I have had strep before, pretty often as a child actually. Never like this though. And then a few weeks later, the nodules and joint pain started back up. I am back on prednisone and seeing a different rheumatologist. This one has prescribed 2 weeks of levofloxacin (500 mg) and 3 weeks of prednisone. She said the strep virus may still be hiding somewhere. She also said that my body is, in essence, now allergic to strep and this will happen every time I get it. Crazy!

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