Erythema nodosum

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Erythema nodosum (EN) is typically characterized by suddenly symmetrically appearing deep painful red nodules on the pretibial area. It rarely recurs, but in some cases it becomes chronic. Histopathologically EN is a septal panniculitis without vasculitis. EN is probably a hypersensitivity reaction to a known or unknown antigen. A physician diagnosing EN always has to consider it as a secondary disease. The most common underlying causes are infections (especially streptococcal), inflammatory bowel diseases, sarcoidosis, and drugs, and it can also be idiopathic. After ruling out erysipelas/cellulitis, thrombophlebitis, insect bite, or urticaria, other panniculitides and vasculitides have to be considered in differential diagnoses. It is self-limited; therefore, the therapy is often only symptomatic besides eliminating or treating aggravating causes. Physical pain relief methods (bed rest and cooling the inflamed skin) are the bases of symptomatic care. EN quickly responds to systemic steroid, but in most cases its use is neither recommended nor necessary. Systemic therapeutic options consist mainly of nonsteroidal anti-inflammatory drugs; in unresponsive cases, potassium iodine, colchicine, dapsone, hydroxychloroquine, thalidomide, TNF alpha inhibitors, and rarely other immunosuppressant and chemotherapeutic agents are the therapeutic options. EN usually resolves without any remaining sign. From the treatment choices, physicians should choose the best according to the possible or proven underlying/aggravating agent and also consider that most of the drugs recommended based on case reports and personal experiences are off-label.

Original languageEnglish
Title of host publicationEuropean Handbook of Dermatological Treatments, Third Edition
PublisherSpringer Berlin Heidelberg
Pages277-283
Number of pages7
ISBN (Print)9783662451397, 9783662451380
DOIs
Publication statusPublished - Jan 1 2015

Fingerprint

Erythema Nodosum
Panniculitis
Vasculitis
Pharmaceutical Preparations
Insect Bites and Stings
Erysipelas
Hydroxychloroquine
Physicians
Dapsone
Streptococcal Infections
Thrombophlebitis
Bed Rest
Thalidomide
Cellulitis
Urticaria
Colchicine
Therapeutics
Immunosuppressive Agents
Sarcoidosis
Inflammatory Bowel Diseases

Keywords

  • Colchicine
  • Corticosteroid
  • Dapsone
  • Erythema nodosum
  • Hydroxychloroquine
  • NSAID
  • Potassium iodine
  • Thalidomide

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Remenyik, E. (2015). Erythema nodosum. In European Handbook of Dermatological Treatments, Third Edition (pp. 277-283). Springer Berlin Heidelberg. https://doi.org/10.1007/978-3-662-45139-7_27

Erythema nodosum. / Remenyik, E.

European Handbook of Dermatological Treatments, Third Edition. Springer Berlin Heidelberg, 2015. p. 277-283.

Research output: Chapter in Book/Report/Conference proceedingChapter

Remenyik, E 2015, Erythema nodosum. in European Handbook of Dermatological Treatments, Third Edition. Springer Berlin Heidelberg, pp. 277-283. https://doi.org/10.1007/978-3-662-45139-7_27
Remenyik E. Erythema nodosum. In European Handbook of Dermatological Treatments, Third Edition. Springer Berlin Heidelberg. 2015. p. 277-283 https://doi.org/10.1007/978-3-662-45139-7_27
Remenyik, E. / Erythema nodosum. European Handbook of Dermatological Treatments, Third Edition. Springer Berlin Heidelberg, 2015. pp. 277-283
@inbook{a8f69b1fed43402bb898d03c09ffa70b,
title = "Erythema nodosum",
abstract = "Erythema nodosum (EN) is typically characterized by suddenly symmetrically appearing deep painful red nodules on the pretibial area. It rarely recurs, but in some cases it becomes chronic. Histopathologically EN is a septal panniculitis without vasculitis. EN is probably a hypersensitivity reaction to a known or unknown antigen. A physician diagnosing EN always has to consider it as a secondary disease. The most common underlying causes are infections (especially streptococcal), inflammatory bowel diseases, sarcoidosis, and drugs, and it can also be idiopathic. After ruling out erysipelas/cellulitis, thrombophlebitis, insect bite, or urticaria, other panniculitides and vasculitides have to be considered in differential diagnoses. It is self-limited; therefore, the therapy is often only symptomatic besides eliminating or treating aggravating causes. Physical pain relief methods (bed rest and cooling the inflamed skin) are the bases of symptomatic care. EN quickly responds to systemic steroid, but in most cases its use is neither recommended nor necessary. Systemic therapeutic options consist mainly of nonsteroidal anti-inflammatory drugs; in unresponsive cases, potassium iodine, colchicine, dapsone, hydroxychloroquine, thalidomide, TNF alpha inhibitors, and rarely other immunosuppressant and chemotherapeutic agents are the therapeutic options. EN usually resolves without any remaining sign. From the treatment choices, physicians should choose the best according to the possible or proven underlying/aggravating agent and also consider that most of the drugs recommended based on case reports and personal experiences are off-label.",
keywords = "Colchicine, Corticosteroid, Dapsone, Erythema nodosum, Hydroxychloroquine, NSAID, Potassium iodine, Thalidomide",
author = "E. Remenyik",
year = "2015",
month = "1",
day = "1",
doi = "10.1007/978-3-662-45139-7_27",
language = "English",
isbn = "9783662451397",
pages = "277--283",
booktitle = "European Handbook of Dermatological Treatments, Third Edition",
publisher = "Springer Berlin Heidelberg",

}

TY - CHAP

T1 - Erythema nodosum

AU - Remenyik, E.

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Erythema nodosum (EN) is typically characterized by suddenly symmetrically appearing deep painful red nodules on the pretibial area. It rarely recurs, but in some cases it becomes chronic. Histopathologically EN is a septal panniculitis without vasculitis. EN is probably a hypersensitivity reaction to a known or unknown antigen. A physician diagnosing EN always has to consider it as a secondary disease. The most common underlying causes are infections (especially streptococcal), inflammatory bowel diseases, sarcoidosis, and drugs, and it can also be idiopathic. After ruling out erysipelas/cellulitis, thrombophlebitis, insect bite, or urticaria, other panniculitides and vasculitides have to be considered in differential diagnoses. It is self-limited; therefore, the therapy is often only symptomatic besides eliminating or treating aggravating causes. Physical pain relief methods (bed rest and cooling the inflamed skin) are the bases of symptomatic care. EN quickly responds to systemic steroid, but in most cases its use is neither recommended nor necessary. Systemic therapeutic options consist mainly of nonsteroidal anti-inflammatory drugs; in unresponsive cases, potassium iodine, colchicine, dapsone, hydroxychloroquine, thalidomide, TNF alpha inhibitors, and rarely other immunosuppressant and chemotherapeutic agents are the therapeutic options. EN usually resolves without any remaining sign. From the treatment choices, physicians should choose the best according to the possible or proven underlying/aggravating agent and also consider that most of the drugs recommended based on case reports and personal experiences are off-label.

AB - Erythema nodosum (EN) is typically characterized by suddenly symmetrically appearing deep painful red nodules on the pretibial area. It rarely recurs, but in some cases it becomes chronic. Histopathologically EN is a septal panniculitis without vasculitis. EN is probably a hypersensitivity reaction to a known or unknown antigen. A physician diagnosing EN always has to consider it as a secondary disease. The most common underlying causes are infections (especially streptococcal), inflammatory bowel diseases, sarcoidosis, and drugs, and it can also be idiopathic. After ruling out erysipelas/cellulitis, thrombophlebitis, insect bite, or urticaria, other panniculitides and vasculitides have to be considered in differential diagnoses. It is self-limited; therefore, the therapy is often only symptomatic besides eliminating or treating aggravating causes. Physical pain relief methods (bed rest and cooling the inflamed skin) are the bases of symptomatic care. EN quickly responds to systemic steroid, but in most cases its use is neither recommended nor necessary. Systemic therapeutic options consist mainly of nonsteroidal anti-inflammatory drugs; in unresponsive cases, potassium iodine, colchicine, dapsone, hydroxychloroquine, thalidomide, TNF alpha inhibitors, and rarely other immunosuppressant and chemotherapeutic agents are the therapeutic options. EN usually resolves without any remaining sign. From the treatment choices, physicians should choose the best according to the possible or proven underlying/aggravating agent and also consider that most of the drugs recommended based on case reports and personal experiences are off-label.

KW - Colchicine

KW - Corticosteroid

KW - Dapsone

KW - Erythema nodosum

KW - Hydroxychloroquine

KW - NSAID

KW - Potassium iodine

KW - Thalidomide

UR - http://www.scopus.com/inward/record.url?scp=84944525505&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84944525505&partnerID=8YFLogxK

U2 - 10.1007/978-3-662-45139-7_27

DO - 10.1007/978-3-662-45139-7_27

M3 - Chapter

AN - SCOPUS:84944525505

SN - 9783662451397

SN - 9783662451380

SP - 277

EP - 283

BT - European Handbook of Dermatological Treatments, Third Edition

PB - Springer Berlin Heidelberg

ER -