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1. ERYTHEMA NODOSUM
R.Anusha,
PharmD V Year,
170514882007
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2. INTRODUCTION
 A painful inflammatory disorder in which crops of tender
nodules occur in response to antigenic stimuli.
 Usually it is limited to the extensor aspects of the lower
legs.
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3. CAUSES:
 Hypersensitivity reaction
 Infection
• Streptcoccus, Mycoplasma pneumoniae
 certain medication
• Antibiotic e.g. amoxicillin
• Sulfonamides
• Birth control pills
 Pregnancy
 Sarcoidosis
 Leukemia
 Ulcerative colitis 3

4. CLINICAL PRESENTATION:
 At the beginning:
• Red tender nodules ,
• Poorly Defined border,
• Vary from 2-6 cm
 During the first week:
• Lesions become tense, hard, and painful
 During the second week:
• They may become fluctuant, as in an abscess, but do not
suppurate or ulcerate.
 Aching legs and swelling ankles may persist for weeks
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5.  Investigations:
• Throat culture for streptococcus
• Chest X-ray for sarcoidosis and TB
• Skin biopsy for difficult cases
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DIAGNOSIS

6. TREATMENT
 Discontinue possible causative medications
 Treatment of underlying infectious diseases mainly
streptococcal and TB
 Bed rest and leg elevation and nonsteroidal anti-
inflammatory drugs (NSAIDs) (Aspirin, Ibuprofen ,
Indomethacin, Naproxen)
 Potassium iodide—saturated solution of
potassiumiodide-5–15 drops three times a day.
• In adults and older children, common dose = 300 mg
TDS with starting dose = 150–300 mg TDS
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7. REFERNCES
 AMERICAN FAMILY PHYSCIAN;ROBERT A.
SCHWARTZ; 2007 march 1;75(5):695-700.
 WWW.MSD.MANUALS.COM;Hypersensitivity and
inflammatory skin disorders.
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