Erythema Nodosum Overview and Insights
Know about erythema nodosum, its symptoms, causes, and treatment options. Gain insights into this inflammatory skin condition and ways to manage it effectively.
Written by Dr. M L Ezhilarasan
Reviewed by Dr. Shaik Abdul Kalam MD (Physician)
Last updated on 1st Sep, 2025
Introduction
Erythema nodosum is a skin condition that causes painful, red, and tender lumps, usually on the shins. While it may look alarming, it is often a sign of an underlying issue rather than a disease itself. This article will help you understand what erythema nodosum is, its causes, symptoms, and how to manage it effectively.
What is Erythema Nodosum?
Erythema nodosum (EN) is an inflammatory condition that affects the fatty layer of the skin, leading to the formation of tender, red, or purple bumps. These lumps are most commonly found on the shins but can also appear on the thighs, arms, or other parts of the body.
The condition is not contagious and often resolves on its own within a few weeks. However, since it can be linked to other health issues, it’s important to identify the underlying cause for proper treatment.
Consult a Dermatologist for the best advice
Symptoms of Erythema Nodosum
The most noticeable signs of erythema nodosum include:
- Painful, red, or purple bumps – Usually on the shins, ranging from 1 to 5 cm in size.
- Tenderness and warmth – The affected area may feel sore and warm to the touch.
- Swelling and bruising-like appearance – Over time, the lumps may turn bluish before fading.
- Flu-like symptoms – Some people experience fever, fatigue, joint pain, or general discomfort before the bumps appear.
These symptoms can last for 2 to 6 weeks, and while they can be uncomfortable, they usually heal without scarring.
What Causes Erythema Nodosum?
Erythema nodosum is often a reaction to an infection, medication, or another medical condition. Common triggers include:
1. Infections
- Streptococcal infections (like strep throat)
- Tuberculosis (TB)
- Fungal infections
- Viral infections (such as hepatitis or Epstein-Barr virus)
2. Autoimmune or Inflammatory Conditions
- Sarcoidosis (an inflammatory disease affecting multiple organs)
- Inflammatory bowel disease (IBD) (like Crohn’s disease or ulcerative colitis)
- Behçet’s disease (a rare disorder causing blood vessel inflammation)
3. Medications
- Antibiotics (like penicillin or sulfa drugs)
- Birth control pills
- Non-steroidal anti-inflammatory drugs (NSAIDs)
4. Other Causes
- Pregnancy (hormonal changes can trigger EN)
- Cancer (rarely, certain cancers may be associated)
Sometimes, the exact cause remains unknown (idiopathic erythema nodosum).
How is Erythema Nodosum Diagnosed?
If you notice painful red lumps on your legs, consult a doctor. Diagnosis usually involves:
- Physical examination – A doctor checks the appearance and location of the lumps.
- Medical history review – To identify infections, medications, or underlying conditions.
- Blood tests – To check for infections or inflammatory markers.
- Skin biopsy – In rare cases, a small skin sample may be taken for further testing.
- Imaging or other tests – If an underlying condition like TB or sarcoidosis is suspected.
Treatment and Management
Since erythema nodosum often resolves on its own, treatment focuses on relieving symptoms and addressing the underlying cause.
1. Symptom Relief
- Rest and elevation – Keeping legs raised can reduce swelling.
- Cold compresses – Applying ice packs wrapped in a cloth can ease pain.
- Pain relievers – Over-the-counter NSAIDs (like ibuprofen) may help, but consult a doctor first.
2. Treating the Underlying Cause
- If an infection is the trigger, antibiotics or antifungal medications may be prescribed.
- If an autoimmune condition is involved, treatments like corticosteroids may be recommended.
3. Lifestyle and Home Care
- Wear loose, comfortable clothing – Tight clothes can irritate the lumps.
- Avoid excessive standing or walking – This can worsen swelling and discomfort.
- Stay hydrated and eat a balanced diet – Supports overall healing.
When to See a Doctor?
While erythema nodosum often improves on its own, consult a doctor if:
- The lumps are extremely painful or spreading.
- Symptoms last longer than 6 weeks.
- You develop fever, joint pain, or other concerning signs.
- You suspect an underlying infection or condition.
If needed, you can book a consultation or schedule tests through Apollo 24|7 for expert guidance.
Final Thoughts
Erythema nodosum can be uncomfortable, but it is usually temporary and treatable. Understanding its causes and symptoms helps in managing it effectively. If you notice persistent or worsening symptoms, seeking medical advice ensures proper care and recovery.
Consult a Dermatologist for the best advice
Consult a Dermatologist for the best advice
Dr. Paulomi Vartak
Dermatologist
2 Years • MBBS, MD (DERMATOLOGY,VENEREOLOGY AND LEPROSY)
Pune
Pramodini Urology Foundation and stree clinic, Pune
Dr. Kavitha Killaparthy
Dermatologist
23 Years • MBBS,DIPLOMA(DERMATOLOGY,VENEREOLOGY,LEPROSY)
Hyderabad
JDS Skin & Hair Clinic, Hyderabad
Dr. Mayuri Jain
Dermatologist
11 Years • MBBS, MD Dermatology , Venereology & Leprosy
Delhi
Dr Mayuri Jain Clinic, Delhi
Dr Ekansh Shekhar
Dermatologist
10 Years • MBBS MD
Lucknow
Apollo Clinic Hazratganj, Lucknow
Dr. Swathi Thadishetti
Dermatologist
14 Years • MBBS, MD (DVL)
Karim Nagar
RKD Hospital, Karim Nagar
Consult a Dermatologist for the best advice
Dr. Paulomi Vartak
Dermatologist
2 Years • MBBS, MD (DERMATOLOGY,VENEREOLOGY AND LEPROSY)
Pune
Pramodini Urology Foundation and stree clinic, Pune
Dr. Kavitha Killaparthy
Dermatologist
23 Years • MBBS,DIPLOMA(DERMATOLOGY,VENEREOLOGY,LEPROSY)
Hyderabad
JDS Skin & Hair Clinic, Hyderabad
Dr. Mayuri Jain
Dermatologist
11 Years • MBBS, MD Dermatology , Venereology & Leprosy
Delhi
Dr Mayuri Jain Clinic, Delhi
Dr Ekansh Shekhar
Dermatologist
10 Years • MBBS MD
Lucknow
Apollo Clinic Hazratganj, Lucknow
Dr. Swathi Thadishetti
Dermatologist
14 Years • MBBS, MD (DVL)
Karim Nagar
RKD Hospital, Karim Nagar
