Erythema nodosum is a toxic-allergic reaction of the vessels of the skin and subcutaneous tissue to a variety of infectious diseases, the most important of which belongs to streptococcal infection (chronic tonsillitis, tonsillitis, scarlet fever) and tuberculous intoxication.
To chronic foci of infection, which are the cause of nodosum erythema, also include venereal lymphogranuloma, iersiniosis, leprosy, coccidioidosis, histoplasmosis. Among non-infectious pathologies, nonspecific ulcerative colitis and a fairly common cause of erythema are sarcoidosis.
The disease is characterized by the appearance of inflammatory knots on the skin of the shins against the background of a violation of the general condition of the patient. In children, erythema nodosum is more severe.
Usually erythema nodosum occurs in childhood and adolescence. In adults, the disease is less common, mainly it affects young women 15-30 years.
Symptoms of erythema nodosum
The acute form of the disease is accompanied by a worsening of the general condition, an increase in temperature to 39 ° C, joint pain, chills, insomnia, gastrointestinal disorders, loss of appetite. On the extensor surfaces of the shins in the dermis layer or subcutaneous tissue appear dense, symmetrically located nodes with a diameter of 1-3 centimeters. They slightly rise above the level of the skin and are painful when pressed.
Above the nodes the skin acquires a bright red color, which then becomes brownish-red, brown and greenish-yellow. The nodes never ulcerate and after 3-4 weeks pass completely or in their place there is a temporary pigmentation and peeling.
Often the nodes recur, new elements replace the disappeared, appearing on the same or other places, and extending the disease to 6-7 weeks.
Chronic erythema nodosum has several varieties: migratory erythema nodosum, more prolonged and prone to relapse, and superficial-infiltrative, large in size, prone to peripheral growth and resorption in the center with the formation of a ring-shaped form. The aggravation is noted in the spring and autumn.
Treatment of erythema nodosum
Treatment of erythema nodosum should be prescribed by a doctor. In acute period the patient needs bed rest. The main attention should be directed to the identification and treatment of the underlying disease that caused the appearance of erythema nodosum.
If there are no indications for tuberculosis, antibacterial drugs of a wide spectrum of action are prescribed. Salicylates, non-steroidal anti-inflammatory drugs such as Naprosin or Brufen, analgesic and anti-inflammatory drugs Reopyrin or Pirabutol are also used.
With a migrating form, it is advisable to use sulfonamide drugs.
In stubborn cases and in the absence of tuberculosis, glucocorticoid agents are prescribed.
Vitamins are recommended: Routine, Aevit, autohemotherapy. In the absence of tuberculosis and other contraindications, dry heat, mercury-quartz lamp, UHF therapy are prescribed.
Compresses of 5-10% solution of ichthyol, absorbing ointments of Vishnevsky or Kreda, ointment of Acemin are externally applied.
When swelling is used diuretics.
In the diet add beans, green beans, dill, basil, caraway seeds.
The prognosis of the disease is favorable.