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What is erythema nodosum?
- Erythema nodosum is a type of skin inflammation that is located in a certain portion of the fatty layer of skin.
- Erythema nodosum (also called EN) results in reddish, painful, tender lumps most commonly located in the front of the legs.
- The tender lumps, or nodules, of erythema nodosum range in size from one to five centimeters. The nodular swelling is caused by a inflammation in the fatty layer of skin.
- Erythema nodosum can be self-limited and resolve on its own in three to six weeks. Upon resolution, it may leave only a temporary bruised appearance or leave a chronic indentation in the skin where the fatty layer has been injured.
What causes erythema nodosum?
Erythema nodosum may occur as an isolated condition or in association with other conditions. Conditions that are associated with erythema nodosum include:
Quick GuideRingworm: Treatment, Pictures, Causes, and Symptoms
What are the signs and symptoms of erythema nodosum?
Characteristic features of erythema nodosum include barely 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 nodular areas are 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 disappear. 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.
How is erythema nodosum diagnosed?
Usually, erythema nodosum is a straightforward, simple diagnosis for a doctor to make by examining a patient and noting the typical firm area of raised tenderness that is red along with areas which have had lesions resolved, which might show a bruised-like appearance. It does not typically require other investigative tests.
Sometimes a biopsy is done for confirmation. For example, if a patient presents with an isolated, nodule and a doctor is unable to make a diagnosis based on its appearance. The biopsy of the deeper layers of tissue of skin can prove that it is erythema nodosum.
Can erythema nodosum be confused with other conditions?
How is erythema nodosum treated?
Erythema nodosum is initially managed by identifying and treating any underlying condition present. Simultaneously, treatment is directed toward the inflamed skin from the erythema nodosum.
Treatments for erythema nodosum include anti-inflammatory drugs, and corticosteroids by mouth or local injection. Colchicine is sometimes used to reduce inflammation. Treatment must be customized for the particular patient and conditions present, such as the existence of any associated diseases. It is important to note that erythema nodosum, while annoying and often painful, does not threaten internal organs and the long-term outlook is generally very good.
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Koopman, William, et al., eds. Clinical Primer of Rheumatology. Philadelphia, PA: Lippincott Williams & Wilkins, 2003.
Ruddy, Shaun, et al. Kelley's Textbook of Rheumatology. 6th ed. Philadelphia, PA: W.B. Saunders, 2001.
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Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used to reduce mild to moderate pain, inflammation, and fever. Ibuprofen works by blocking an enzyme that makes prostaglandin (a hormone-like substance that participates in a variety of body functions), which results in lower levels of prostaglandins in the body. Lower levels of prostaglandins reduce pain, inflammation, and fever.
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Common side effects of ibuprofen include, diarrhea, constipation, nausea, heartburn, belly pain, drowsiness, headaches, tinnitus (ringing in the ears), and mild rash.
More serious side effects and adverse effects include, increased bleeding after injury, stomach ulcers, impaired kidney function, severe allergic reaction (anaphylaxis), blood clots, heart attack, heart failure, and high blood pressure.
The maximum dose prescribed under a doctor's care is 3.2 g daily. Otherwise, the over-the-counter (OTC) maximum daily dose is 1.2 g daily. Dosage depends upon the age, weight, and any current medical conditions of the patient. Several drugs interact with ibuprofen so check with your doctor, pharmacist, or other health care professional with questions in regard to this drug. Doctors don't know if it is safe to take ibuprofen if your are pregnant, therefore it is not recommended if you are pregnant. According to the American Academy of Pediatrics, ibuprofen is safe to take while breastfeeding.
REFERENCE: FDA Prescribing Information.
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If you notice other effects not listed above, contact your doctor or pharmacist. In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
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