Complications of Erythema Nodosum
The complications of erythema nodosum are generally mild, especially when the condition is short-lived and the cause is treated. However, erythema nodosum can lead to physical, emotional, and sometimes systemic issues if it becomes chronic or is associated with an underlying illness.
Pain and Reduced Mobility
Painful nodules on the legs can make walking or standing difficult. This may result in:
Reduced physical activity
Difficulty at work or school
Temporary reliance on mobility aids in severe cases
In children and working adults, this may cause significant disruption to daily routines.
Recurrence
Some individuals experience recurrent erythema nodosum, particularly when the trigger is not identified or remains untreated. This may occur:
During future infections
With certain medications
In chronic autoimmune or inflammatory diseases
Repeated episodes can lead to frustration and reduced quality of life.
Skin Discolouration and Scarring
Although erythema nodosum typically resolves without scarring, some patients may develop:
Bruise-like discolouration for weeks after the lesions fade
Hyperpigmentation, especially in individuals with darker skin
Thickened or hardened skin, rarely, if inflammation was deep or prolonged
Emotional Impact
Visible, painful lesions can cause embarrassment, particularly when they affect the legs in warm weather. Patients may feel:
Self-conscious about their appearance
Anxious about the possibility of recurrence
Frustrated by delayed diagnosis or lack of treatment
Support and education about the condition help reduce stress and encourage compliance with treatment plans.
Complications from Underlying Conditions
The most serious complications usually stem from the underlying disease, not from erythema nodosum itself. For example:
Untreated TB can lead to lung damage and systemic infection
Inflammatory bowel disease may require long-term immunosuppressive therapy
Sarcoidosis, if active, can cause lung, eye, or nerve complications
Therefore, it is critical to investigate and manage the root cause, not just the skin symptoms.
Complications of Erythema Nodosum In South Africa
In South Africa, complications may be more common due to late diagnosis, especially in rural areas. Limited access to tests, specialists, or appropriate medication can result in prolonged symptoms or untreated infections. Strengthening referral systems and community awareness can help reduce complications.
The complications of erythema nodosum are usually preventable. Early identification, treating the cause, and managing symptoms properly can lead to full recovery with minimal long-term effects.
