Symptoms of Erythema Nodosum
The symptoms of erythema nodosum are mostly limited to the skin but may be accompanied by systemic signs depending on the underlying cause. Erythema nodosum typically begins with general flu-like symptoms, followed by the appearance of painful red lumps on the legs.
Skin Symptoms
Tender red nodules – Usually located on the front of the shins, but may also appear on the thighs, arms, or trunk
Symmetrical distribution – Lesions typically appear on both legs
Size – Nodules range from 1 to 5 cm in diameter
Colour changes – Lesions start red, then become bluish or purple before fading to yellow or green like a bruise
Pain or tenderness – Especially when touched or with pressure
New nodules may appear for one to two weeks, and each lesion lasts about two weeks before resolving.
General Symptoms
Many people experience:
Fever
Fatigue
Joint pain, especially in the knees or ankles
Swollen ankles or legs
Headache or malaise
These systemic symptoms often occur before or alongside the skin eruption. They may be mistaken for a viral infection or flu in the early stages.
Duration
The full course of erythema nodosum usually lasts between three and six weeks. In some cases, the condition recurs, particularly if the trigger isn’t identified or resolved.
In Children
Children may have milder lesions, but they often present with fever, sore throat, and joint pain. A streptococcal infection is the most common cause in this age group.
Symptoms of Erythema Nodosum In South Africa
In South Africa, clinicians should be alert for TB in any patient presenting with erythema nodosum and constitutional symptoms like fever or weight loss. Patients with HIV may also show more severe symptoms or slower resolution.
Prompt recognition of the symptoms of erythema nodosum allows doctors to manage discomfort while identifying any underlying medical cause. This ensures both symptom relief and appropriate long-term care.
[Next: Diagnosis of Erythema Nodosum→]
