Erythema nodosum

Erythema nodosum affects the fatty layer beneath the skin. It commonly appears as painful, warm red or purplish nodules on the shins, though other sites can be involved. The bumps may feel bruised and can change colour while they settle; they do not normally form a surface ulcer.

The condition is a reaction pattern rather than a single cause. It may follow an infection, a medicine, or an inflammatory illness such as sarcoidosis or inflammatory bowel disease. Some people have no clear trigger. A clinician looks at the skin and asks about fever, joint symptoms, cough, digestive symptoms and recent medicines.

Rest painful legs, raise them when sitting and use a cool compress for short periods. Loose clothing can reduce rubbing. Keep track of when the nodules began, whether new ones appear and any illness or medication change around that time. Arrange a medical review for a first episode, recurring nodules or pain that affects normal activity.

Treatment depends on the suspected trigger and your overall health. A clinician may recommend symptom relief and, when appropriate, prescription anti-inflammatory treatment. Oral corticosteroids may be considered for selected cases after the assessment is complete.

Seek prompt medical care for trouble breathing, chest pain, fainting, high fever, rapidly spreading redness, severe swelling, inability to walk, or eye pain and vision changes. Contact your clinician if symptoms recur, do not begin to improve, or come with persistent cough, marked fatigue or swollen joints.

Does the examination fit erythema nodosum? What possible trigger should we investigate first? Which pain medicines are safe with my health conditions? When should I return if the skin changes?