Can Children Get Erythema Nodosum?

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Ask the experts

I have a seven-year-old daughter who was just diagnosed with Erythema Nodosum. I have a highly respected pediatrician following her, and I have managed to raise the eyebrows of 3 other pediatricians and 1 dermatologist. Knowing that this is a rare diagnosis for children, I just need more information.

Four days ago, my daughter presented with 5-6 2-3 cm nodules, hard, blue/red in color distributed on the ball of her left foot(only one foot), and in the middle of her instep. These nodules were accompanied by redness and puffiness of the entire foot and middle toes, with no localized pustulance or significant red streaking. It was very painful for her to walk, consequently she elevated and stayed off her foot for 2 days.

On the third day, I gave her children's TYLENOL (acetaminophen) (a mild anti-inflammatory drug) and the swelling somewhat resolved, with some decrease in size of the nodules.

Possible causes may not be so concerning given that she started playing soccer and played hard on the day before symptoms arose - and may have irritated the bottom of her foot with some new cleats - however, she is always active and running and has never shown this before.

Also, at about the same time, she became congested with postnasal drip, bronchial irritation and coughing. Low grade temperatures over 2 days - never over 100.2. No sore throat - a strep culture was taken yesterday, with no results as of 18 hours later. She is not on any regular medications - and besides getting frequent colds with a history of ear infections - she has been a healthy child.

We do have a cat in the house, but she was not scratched. No cold sores or other lumps have been noted on any other part of her body. No other joint pain was reported.

Doctor's response

We would suggest you our full medical article on Erythema Nodosum for further information.

You are a fine medical observer. Your description of your daughter's case is of value to other parents and patients. Thank you for sharing it.

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Reviewed on 1/11/2018