Erythema nodosum is an inflammation of the skin and subcutaneous adipose tissue. The result of this inflammation is the appearance of painful red nodules, which can be the size of a cherry, and in some cases reach the size of an orange. The development of erythema nodosum may be a symptom of another disease, but in 30% of cases it is not possible to establish it, and erythema is considered as a separate independent disease.
Erythema was first described in 1889 by a German doctor named A. Tschamer, while other experts considered it not an independent disease, but an atypical form of rubella. The author of the first detailed description of the erythema clinic in adults was N.K. Rosenberg.
Possible causes of erythema nodosum are:
- taking medications, namely iodides, oral contraceptives, bromides and sulfonamides;
- streptococcal infections, tuberculosis and other infectious diseases;
- rheumatoid arthritis and other autoimmune diseases;
- chronic intestinal diseases - ulcerative colitis, Crohn's disease, etc .;
- tumor diseases;
- pregnancy.
The main role in the development of erythema nodosum is played by sensitization of the vessels of the subcutaneous tissue and skin by the causative agents of infectious diseases. Most often, erythema nodosum occurs after infections such as tuberculosis, streptococcal tonsillitis, leprosy and various fungal infections, less commonly with medication.
It is customary to distinguish between chronic and acute forms of this disease. The acute form of erythema is characterized by a rapidly appearing rash of bright red painful edematous nodes on the legs (larger than a walnut). General weakness, fever up to 38.5–39 ° C, headache and arthralgia are also noted. Edematous nodes disappear after two or three weeks without a trace, gradually changing its color like a “bruise bloom”, ulceration of the nodes is not found. Most often, acute erythema nodosum occurs in children and young women.
Nodular erythema of a chronic form often occurs in elderly women, it is characterized by a relapsing course, weighed down by foci of chronic infection, as well as general allergic or vascular diseases. The period of exacerbation of the disease is spring and autumn, which is characterized by the appearance of a small number of moderately painful inflammatory nodes that have a bluish-pink color and the size of a hazelnut. The main place of localization is the shins and thighs, very often rashes are accompanied by swelling of the limbs. Sometimes ulceration of the nodes occurs. Relapses of chronic erythema can last several months.
Erythema nodosum: treatment
Treatment of acute erythema includes the following measures: full bed rest, taking antibiotics and dipyrone, warming compresses on the affected area with a solution of ichthyol and applying a solution of dimexide. In addition, butadiene and corticosteroid ointments are used.
If primary, minor rashes can still be cured on their own using non-steroidal anti-inflammatory drugs, as well as using elastic stockings and bandages, then if a rash appears again, you should immediately consult a specialist.
The most common mistakes of self-medication are the prolonged use of hormonal ointments, herbal and homeopathic medicines. Prevention of nodular erythema consists in the speedy elimination of all chronic foci of infection in the body. Subcooling should also be avoided. Prevention with the use of medications is usually carried out in spring and autumn, one to two months before the period of the alleged exacerbation of the disease.