What disease can be hidden behind a diagnosis of erythema nodosum

Summary

Erythema nodosum is the most common form of panniculitis. It may occur separately or as a part of wide range of many diseases. The clinical manifestation consists of an acute onset of painful erythematous nodules, which are located most often on the anterior surface of the lower extremities. The nodules subsequently change the color from merely yellow to green. These lesions do not have a tendency to necrosis and resolve spontaneously within 2–8 weeks without leaving scars. Onset of the disease may be accompanied by systemic symptoms such as fever and arthralgia.

Erythema nodosum occurs three to five times more often in female patients. It can occur in all age groups, but it is typically seen between the second and the fourth decades of life. Skin biopsy and histological finding of septal panniculitis without vasculitis may be of benefit, when the clinical picture is inconclusive.

Key words:
erythema nodosum, panniculitis, Miescher's radial granulomas, paraneoplastic symptom, Hodgkin's lymphoma