Erythema Nodosum (cont.)

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How is erythema nodosum diagnosed?

Usually, erythema nodosum is a straightforward, simple diagnosis for a doctor to make simply 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 is not a difficult diagnosis for an experienced doctor. It does not typically require other investigative tests.

Sometimes a biopsy is done for confirmation, for example, if a patient presented with an isolated, singular area and a doctor was 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. Those layers would show the specific inflammatory changes in the tissues.

Can erythema nodosum be confused with other conditions?

The nodules of erythema nodosum are sometimes confused with insect bites. Sometimes the inflammation of erythema nodosum is more widespread and can mimic skin infection (cellulitis).

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 cortisone by mouth or local injection. Colchicine is sometimes used effectively to reduce inflammation and prevent recurrence. 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.

REFERENCES:

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.


Medically Reviewed by a Doctor on 8/26/2014

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