Erythema nodosum and sarcoidosis

Erythema nodosum causes tender, warm, red or purplish bumps, often over the shins. The skin inflammation reflects activity in the fatty layer beneath the skin. Sarcoidosis is an inflammatory condition that can affect several organs, including the lungs, lymph nodes, eyes and skin. A person with erythema nodosum may have sarcoidosis, an infection, a medication reaction or another inflammatory condition; the skin finding alone cannot identify the cause.

A clinician may ask about cough, breathlessness, fever, joint pain, recent infections, new medicines and eye symptoms. Examination and selected tests help decide whether sarcoidosis or another trigger needs evaluation.

Arrange a clinical assessment if the lumps are new, recurring or interfering with walking. Resting the legs, elevating them and using a cool compress may ease discomfort. Wear loose clothing around tender areas and avoid pressing or rubbing the bumps. Do not start anti-inflammatory or steroid medicine without checking whether it is suitable for you, especially if infection is possible.

If sarcoidosis is being considered, ask which organs need assessment and whether follow-up is needed after the skin settles. Treatment is directed at the underlying cause; oral corticosteroids may be considered in selected situations.

Seek prompt medical care for breathing difficulty, chest pain, fainting, marked eye pain or vision change, a high fever, rapidly worsening swelling, or inability to walk because of pain. Contact a clinician soon if symptoms keep returning or are accompanied by persistent cough, swollen joints, unusual fatigue or unexplained weight change.

Could sarcoidosis explain my skin and other symptoms? Which examination or tests are appropriate? What medicines should I avoid? How will we monitor my lungs, eyes or joints?