• Erythema Nodosum


    Erythema nodosum is the name given to tender lumps on the legs and sometimes the arms. They are caused by inflammation of the fat or connective tissue beneath the skin.
    Erythema Nodosum
    Erythema  Nodusum
    Copyright © Nucleus Medical Media, Inc.


    Erythema nodosum is thought to be a type of autoimmune reaction. It may be caused by:
      Infections from a:
      • Virus
      • Bacteria, especially strep throat
      • Fungus
      Inflammatory conditions: Medications:
      • Sulfa drugs and some other antibiotics
      • Iodides
      • Bromides
      • Birth control pills
      • Leukotriene modifiers
      • Proton pump inhibitors
      Certain types of cancer:
      • Lymphoma
      • Leukemia
    Sometimes the cause of erythema nodosum is not known.

    Risk Factors

    This condition is rare. It is more common in females and young adults aged 20-30 years old.
    Having any of the causes listed above will only slightly increase your risk of the disorder.


    Symptoms include:
      Very tender, deep lumps, like bruises, that change color in the same way, from pink to blue to brown:
      • Usually located on your shins
      • May also appear on the forearms, trunk, neck, and head
    • May be associated joint pain and fever and redness around the eyes


    You will be asked about your symptoms and medical history. A physical exam will be done, which may diagnose the problem based on a visual exam. You may be referred to a doctor that focuses on skin problems or infectious diseases.
    Your bodily fluids and cells may be tested to look for a cause. This can be done with:
    • Blood and urine samples
    • Cultures or a throat swab for strep
    • PPD skin test for tuberculosis
    • Biopsy of a lesion
    Images may be taken of your bodily structures. This can be done with a chest x-ray and other imaging tests.


    If a cause can be identified, it will be treated. For the nodules themselves, pain relief is all that is needed. They tend to resolve on their own in about 6 weeks. They will not cause scarring. Treatment options include the following:

    Pain Relief

    Pain relief includes:
    • Bed rest and elevation of legs
    • Wet compresses
    • Aspirin, except in children
    • Nonsteroidal anti-inflammatory drugs (NSAIDs)
    • Potassium iodide

    Other Treatment

    Other medications such as steroids, may be necessary in severe cases.


    Some of the infectious causes can be avoided by practicing good hygiene, which includes:
    • Washing your hands often
    • Not sharing food, drinks, or utensils


    American Academy of Dermatology https://www.aad.org

    Family Doctor—American Academy of Family Physicians https://familydoctor.org


    Canadian Dermatology Association https://dermatology.ca

    Health Canada https://www.canada.ca


    Erythema nodosum. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116219/Erythema-nodosum Updated February 23, 2016. Accessed August 18, 2017.

    Erythema nodosum. DermNet New Zealand website. Available at: https://www.dermnetnz.org/topics/erythema-nodosum. Accessed August 18, 2017.

    Erythema nodosum. Better Health Channel website. Available at: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/erythema-nodosum. Updated April 2016. Accessed August 18, 2017.

    Requena L, Yus ES. Erythema nodosum. Dermatol Clin. 2008;26(4):425-438.

    Revision Information

  • LiveWell personal health survey

    How healthy are you really? Find out – free.Learn more

    It's time to stop guessing. If you want to make some changes but just aren't sure how, the free personal health survey from LiveWell is a great place to start.

  • HeartSHAPE Spotlight

    At risk for a heart attack? Learn more

    Fight heart disease and prevent heart attacks. HeartSHAPE® is a painless, non-invasive test that checks pictures of your heart for early-stage coronary disease.

  • Calories and Energy Needs

    Calorie NeedsLearn more

    How many calories do you need to eat each day to maintain your weight and fuel your physical activity? Enter a few of your stats into this calculator to find out.

  • Ideal Body Weight

    Ideal Body WeightLearn more

    Using body mass index as a reference, this calculator determines your ideal body weight range. All you need to do is enter your height.

  • Body Mass Index

    Body Mass IndexLearn more

    This tool considers your height and weight to assess your weight status.

  • Can we help answer your questions?

    Wellmont Nurse Connection is your resource for valuable health information any time, 24 hours a day, seven days a week. Speak to a Nurse any time, day or night, at (423) 723-6877 or toll-free at 1-877-230-NURSE.