Erythema nodosum: causes and treatment methods. Causes and treatment of erythema nodosum of the legs Erythema nodosum on the legs causes and treatment

One of the easily recognizable ailments is erythema nodosum on the legs. Is this rash considered harmless or is it fraught with a serious pathology? The answer to this question lies in the causes of the disease.

Erythema nodosum (photos showing the visual manifestation of the disease are below) is an inflammation of the skin and fatty tissues. As a result, red nodules form on the surface. Their size can vary from the diameter of a cherry to the corresponding parameters of an orange. This phenomenon can be a symptom of various ailments. But often the true nature of the disease cannot be established. Therefore, erythema nodosum on the legs is considered in most cases as an independent disease.

Rashes on the surface of the skin are nodules of red color. They are quite painful. Even a slight touch is fraught with increased discomfort. It clearly demonstrates how erythema nodosum manifests itself, photo. As a rule, rashes rise slightly above the surface of the skin.

Nodules are localized mainly on the anterior surface of the legs, on the knees, and thighs. Rarely, rashes can occur on the hands, face, or neck.

The initial stage is characterized by bright red rashes. The further course of the disease is characterized by a change in the shade of neoplasms. The nodules acquire a purple color, which subsequently changes to brown.

As a rule, rashes remain on the surface of the skin for 5 to 10 days. Further, over the course of 3-6 weeks, the nodules gradually disappear.

As noted above, the source of the disease is not always possible to accurately establish. The main reasons why erythema nodosum occurs on the legs (for a photo of the characteristic manifestations, see the article) include tuberculosis intoxication and streptococcal infection.

Sometimes an ailment is the initial symptom characteristic of the following diseases:

fungal or bacterial infection;
tuberculosis;
inflammatory bowel processes;
syphilis;
cancer (very rare);
sarcoidosis;
Behçet's disease.

Often, the disease develops as a result of a reaction to the following groups of drugs:

antibiotics;
sulfones;
sulfonamides;
oral contraceptives.

Several factors are known to contribute to the development of the disease. These include:

prolonged exposure to cold on the body;
malfunctions of the endocrine system;
hypovitaminosis (overabundance of vitamins C and P);
congestion in the limbs.

The most characteristic symptom of the disease are nodules. Initially, these seals are hard, flat, and feel hot to the touch. Sometimes accompanied by other signs of erythema nodosum. Symptoms may be as follows:

general malaise;
redness;
joint pain;
swelling of the legs;
skin irritation.

There are two types of this disease:

Acute erythema nodosum. This form is often accompanied by a strong increase in temperature. It is characterized by the presence of pain in the joints, muscles. Such rashes are characteristic of a disease that manifests itself in childhood. Sometimes the onset of the disease is the body's reaction to tuberculosis.

Chronic nodular erythema. This is a migratory form. It has a long subacute course with frequent relapses. Nodes have somewhat fuzzy borders. This form is found mainly in elderly and middle-aged women who have vascular or allergic ailments. Another prerequisite for the development of the disease is the presence of a chronic infection in the body.

The disease is more common in girls who have reached the age of six. Rashes on the surface of the skin occur, as a rule, in cold weather. Symptoms of the disease appear on the sixth day.

Erythema nodosum in children is characterized by general malaise, whims. There is pain in the joints and in the abdomen. Hot, rather painful knots appear on the body.

Often the disease is combined with damage to the joints. In this case, the latter swell, redness, pain during movement appears. Inflammation in the joints disappears after a few days, but the pain persists for some time.

Erythema nodosum on the legs is treated with anti-inflammatory drugs. Often prescribed drugs such as Aspirin, Indomethacin, Brufen. Local warming compresses are applied to the affected areas. For them, heparin ointment, ichthyol solution is used. It is very important to notify the doctor about the child's illness. It should be remembered that self-treatment of the disease is quite dangerous.

The disease does not affect the fetus at all. However, erythema nodosum can be dangerous for a pregnant woman. The consequences of the disease sometimes manifest themselves in the form of complications on the heart.

If there are no exacerbations, the patient is prescribed local treatment. The affected areas are lubricated with the Indovazin Ointment. Inside take the drug "Kurantil". In small doses, the drug "Paracetamol" is prescribed. To reduce inflammation, the minimum dosage of Aspirin is recommended. The treatment includes Deep Relief ointment. The drug "Diclofenac" is prescribed in injections.

An important condition for treatment during pregnancy is the full observance of the correct regimen of rest and work. It is necessary to minimize the load on the lower extremities, but it cannot be completely excluded, because the vessels of the extremities must constantly be in good shape.

A patient who turns to a doctor with unpleasant symptoms will be prescribed an X-ray examination of the lungs. This analysis will make it possible to exclude sarcoidosis and tuberculosis. A smear is taken for the presence of streptococcus. To exclude various infections, all kinds of blood tests are carried out.

How to treat erythema nodosum? Initially, you should get rid of negative thoughts and restore peace of mind. After all, they are the source of destruction of the whole organism. It is very important to eat right and lead a healthy lifestyle. It is recommended to cleanse the body of toxins. Particular attention should be paid to the intestines and liver. You can periodically starve or apply one of the weight loss diets. The most recommended are the following: vegetable, berry, buckwheat, kefir, fruit.

As a rule, for the treatment of an ailment, the doctor prescribes the following:

antipyretic drugs;
non-steroidal anti-inflammatory drugs ("Nimesil", "Indomethacin", "Ibuprofen");
antibiotics (if an infectious process is detected);
vitamins C, P;
hormones (in case of an allergic process);
autohemotherapy;
heparin ointment;
plasmapheresis;
compresses;
wraps.

Many amazing recipes can be gleaned from healers. Traditional medicine will tell you many ways to get rid of such an ailment as erythema nodosum. Treatment with folk remedies is an auxiliary therapy. It should be combined with medication. In this case, the results will be much better.

Folk recipes:

Chop the arnica flowers. Pour boiling water (200 ml) in a thermos. Leave the infusion all night. In the morning, the remedy should be filtered. Throughout the day, the infusion is taken in 1 tsp. at least five times.
Choleretic agents have an excellent effect. They are made from berries and medicinal herbs. Melissa, lingonberry leaves, immortelle, birch, yarrow and mint, taken in equal parts, are brewed as follows: 1 tbsp. a spoonful of this collection for 0.5 liters of boiling water. 15 minutes before meals, drink a third of a glass of medicinal infusion.
To prepare an anti-allergic remedy, you will need bittersweet nightshade, string, knotweed, golden rod. All ingredients are taken in equal proportions. Mix ingredients thoroughly. To make a decoction, you need 1 tsp. collection. It is poured with one glass of boiling water. The solution should be held for two minutes on low heat. Within an hour, the remedy should be infused. Healing decoction is used three times a day. It is advisable to take it before meals.

To prepare an effective tincture, you will need red elderberries. Ten grams of this component is poured with vodka. The last thing you need to take is 0.5 liters. It is recommended to insist the mixture for 40 days. After this period, the drug is ready. It should be taken once before bed. The dosage is calculated based on the weight of the patient. A patient with a body weight not exceeding 70 kg should take 20 drops of the drug. If the weight exceeds the indicated one, it is recommended to increase the dose to 30 drops. This tincture is advised to seize. For such purposes, black bread grated with garlic or poured with sunflower oil is suitable. The course of taking this remedy should last 1 month. For the next 30 days, you should take a break, and then resume the course of treatment again.
In the fight against the disease, baths have proven themselves. For them you will need: willow and oak bark, walnut fruits, black elderberry and linden flowers, raspberry sprigs, nightshade grass. If it is not possible to find all the above components, it does not matter. Use the ingredients you can get. Grind them carefully. Pour boiling water over one tablespoon of the prepared collection (1 liter). Leave the resulting mixture for 15 minutes, then pour the infusion into the bath. After stirring the water, lie down in it. The duration of the procedure is a quarter of an hour.

If the disease is classified as independent, then it does not pose a threat to the body. At the same time, it is very important to carry out the therapy of all concomitant ailments in a timely manner, since they can be fraught with danger.

Another important nuance is the timely treatment of the disease. Running erythema nodosum is fraught with rather unpleasant complications. The consequences can be quite unpleasant. One of them is the transition of the disease into a chronic form.

Erythema nodosum on the legs is a fairly common ailment. Its development, as a rule, causes sensitization of the vessels of the subcutaneous tissue. Often, pathology in the body is caused by an infection or non-acceptance of certain medications. Sometimes these rashes can act as symptoms of a completely different ailment.

The cause of redness of human skin, especially the face, is anger or shame, other psychological, mechanical or chemical effects are possible: sunburn, cold wind, massage. But when the redness continues, the development of a disease called erythema is likely.

Erythema is a pathological change in human skin, it becomes knotty and rough, bumps appear on the legs, warts appear, formations are painful and can change color. The size of the nodules can vary from a small pea to the size of an apple. At first, the knotted cone turns red, then the color changes to purple, at the end it becomes brown or yellowish. Often people do not pay attention to the process, assuming bruises and catch on when time has already been lost.

Redness of the legs

Symptoms

Coming to the doctor, many complain in approximately the same way: a year ago, the disease passed, the state of health is satisfactory, they went to the sea, and suddenly: there is an aggravation on their legs, a reddish nodular bump appears again, and it itches. The skin around the growth looks like a geographical map, I feel bad, lethargy, I constantly want to sleep. There is a typical picture of acute and chronic skin disease.

The cause of the disease is drug allergies, infections, streptococcal infections, diseases of the gastrointestinal tract, the use of birth control pills, and so on. A person is not able to make a diagnosis on his own, a serious illness develops, similar to other skin diseases.

Coming to the doctor, you will definitely need to undergo an examination with:

dermatologist;
rheumatologist;
therapist.

Having found out the cause of the disease, the nature of the disease, the doctor prescribes treatment. Consider the essence of the disease and its varieties.

Contacting a specialist

The disease is characterized by three main types of diseases:

diverse infectious diseases: tonsillitis, scarlet fever, tuberculosis and others;
non-communicable diseases - sarcoidosis affecting the lungs, lymph nodes, spleen, ulcerative colitis;
multiple allergies.

For the first time, in the eighteenth century, dermatologists began to distinguish erythema nodosum from allergic vasculitis. The key difference is that with the first disease, the vascular system is affected, it becomes difficult for a person to walk.

Unfortunately, erythema on the legs is a young disease that affects young people from twenty to thirty years old, men and women, but children endure the disease more severely. Girls of six years are more likely than other children to suffer from pathology. At first, fatigue appears, the children begin to ache in the stomach and joints, the girls begin to act up, hot nodules appear on the legs or in the body, which the children do not allow to touch.

Joints often become inflamed, swollen, redden and hurt when walking. After a while, the swelling subsides, but the pain continues. In babies, the disease often occurs if the child has had tuberculosis. A sick child is supposed to be immediately hospitalized, you cannot treat yourself or lubricate the patient's body with homemade ointments.

The treatment of pregnant women is more difficult, expectant mothers primarily take care of the fetus, they do not want to take potent drugs. For the unborn baby, the disease is not dangerous, but it can adversely affect the health of the mother. The heart takes the brunt of the disease. Doctors recommend bed rest for pregnant women or advise to lie down for preservation. You can not be loaded with problems, carry heavy things. The disease does not disappear completely, it can take a chronic form, worsen in the cold season.

Special preparations have been developed. If the erythema is infectious, it is better to use antibiotics: penicillin, tetracycline, streptomycin. It is necessary to take the tablets according to the schedule prescribed by the doctor, and the treatment will take one to two weeks. Erythema will pass faster if prednisone is added to the medication.

Anti-inflammatory drugs have a good effect on the body: ibuprofen, acetylsalicylic acid, metindol, potassium iodide (no more than 900 milligrams per day, for two to four weeks). If the erythema is acute, a connection with the menstrual cycle has been revealed, it is possible to use birth control pills to treat the disease, it is permissible only after consulting a gynecologist.

Physiotherapy can effectively affect the foci of the disease. A knotty bump or growth lends itself well to laser therapy, usually doctors prescribe a method if they are sure that patients have no prejudice to physiotherapy. The patient is selected individual treatment, depending on the age and severity of the disease.

Vishnevsky ointment

A method is prescribed for babies: smear the affected areas with Vishnevsky's ointment, acemin, and prescribe vitamins. If the treatment for a week did not help, the child is checked for the presence of diseases - rheumatism, tumor formations and gastric diseases.

With a mild course of the disease in pregnant women, doctors offer ointments indovazin, diclofenac. It is recommended to drink aspirin, paracetamol along with ointments, reduce the load on the legs. It is important for expectant mothers with erythema nodosum disease of the legs to contact practicing and specialized doctors, to be treated under medical supervision.

A knotty, smallpox-like disease that occurs on the legs is treated at home. The patient regularly visits the doctor, becomes registered, examined, fulfills the requirements of the doctor. In the clinic, the patient is examined by a pulmonologist, checks for contagious diseases by an infectious disease specialist, the patient is referred to an otolaryngologist, phlebologist, and vascular surgeon.

Erythema nodosum on the legs is determined using modern diagnostics, showing in detail the severity of the disease. Doctors are helped by rhinoscopy, computed tomography, x-rays of the lungs. In case of emergency, the patient is hospitalized to cure the underlying disease (for example, tuberculosis).

Diagnosis of skin disease

Folk methods of treatment

Folk remedies for the treatment of erythema are popular among people, play a big role in the improvement of the population. Many recipes are known. Example: take raspberry, blackberry leaves, add birch buds and plantain leaves.

Cut the leaves, melt castor oil, mix in equal proportions, put in a water bath and simmer for sixty minutes over low heat. Then strain hot through cheesecloth, cool, lubricate problem areas twice a day.

A proven folk recipe: rub one hundred grams of arnica root in a mortar, mix the powder with lard, cook over low heat for three hours, do not forget to stir. Treatment will give a good effect if you lubricate the skin three times a day.

Doctors recommend treatment in a similar way: prepare decoctions, add to the bath, the nodular rash will quickly pass. You can prepare decoctions made from oak bark, willow bark, use walnuts, decoctions from flowers or sprigs of raspberries and elderberries.

New decoction: grind nettle, take a spoonful of raw materials and pour a liter of boiling water, wait fifteen minutes, pour into a bath, take no more than twenty minutes.

You can prepare a collection of herbs: dry, chop the herbs, take a tablespoon of the collection and half a liter of boiling water, leave for thirty minutes and take twenty minutes before meals. The dose consists of the third part of a spoon.

If erythema is a symptom of an infectious disease, its prevention is possible. If it becomes an independent disease, it is almost impossible to prevent the disease. Unfortunately, scientists have not yet identified the causative agents of the disease.

The patient's leg is knotty with a small rash, shows severe pain, without treatment and prevention there is a chance to start the disease to a chronic one. To prevent the disease, it is shown to exercise regularly, do not smoke, do not drink alcoholic beverages, monitor immunity.

Certain types of drugs cannot be used for secondary prevention of the disease. During the examination, the doctor will suggest safety measures and write out the necessary prescription. Patients are encouraged to follow a diet. It is useful to cook food that includes legumes and various herbs. It is important to keep your feet warm, not to get sick with the flu.

Erythema is not dangerous to humans, but so that the skin does not look like a geographical map, and there are no painful sensations on the legs, it is required to lead a normal life. The appearance of the disease is unpleasant, it can provoke temperature, irritation, muscle and joint pain, it becomes the cause of serious diseases, treatment will be problematic. Therefore, to be examined by a doctor is the first thing to do.

Erythema nodosum is called inflammation of blood vessels and subcutaneous fatty tissue on the legs or arms. The disease can develop in patients of different ages, both in men and women. By itself, the pathology is not dangerous. However, often erythema nodosum indicates the development of other diseases.

The disease got its name due to the characteristic symptoms. On the affected areas, most often in the lower extremities, dense nodes begin to appear, with a diameter of 5 mm to 5 cm. In the medical literature, you can also find the name erythema nodosum. Experts attribute pathology to varieties of allergic vasculitis. Inflammation of the walls of blood vessels develops as a reaction of the body to the effects of various toxic factors.

Most often, pathology is faced by young people aged 20-30 years. Statistics show that women develop the disease more often. Exacerbation in most cases occurs in the winter-spring period.

Rashes can develop in adults as an independent disease. In this case, the pathology is primary. If inflammation of the vessels occurs against the background of another pathological process in the body, we are talking about secondary erythema nodosum. The disease can develop on the arms or legs. Most often, unpleasant symptoms appear on the lower extremities.

Depending on the causes of the disease, the following types are distinguished:

Infectious erythema. The disease develops against the background of various infections in patients of any age.
Multiform exudative erythema. The disease develops against the background of a cold, may be accompanied by pain in the throat, joints. Nodes are formed not only on the limbs, but also on the oral mucosa, in the genital area.
Annular erythema. The disease is classified as chronic. Pathology can develop against the background of allergic reactions, a prolonged illness of an infectious nature. Round nodules eventually merge into rings.
migratory erythema. Pathology is manifested due to a tick bite.

Toxic erythema is a disease that develops in a child in the first days of life. Small red seals appear on the baby's body. After a few days, the rash goes away on its own. No special treatment is required.

The disease can manifest itself in an acute form. But more often you have to deal with secondary chronic inflammation. To completely remove unpleasant symptoms, it is necessary to cure the underlying disease.

The development of inflammation of blood vessels and subcutaneous adipose tissue is most often promoted by various infectious processes in the body. Unpleasant symptoms can develop as a result of diseases:

angina;
cystitis;
otitis;
streptoderma;
tuberculosis;
rheumatoid arthritis;
scarlet fever, etc.

Nodules on the skin can develop as a side effect of drug therapy. Often, erythema nodosum appears after vaccination or antibiotics.

People suffering from oncological pathologies also have to deal with inflammation of the vascular walls. People with lymphoma are most susceptible to erythema nodosum. People with blood and vascular diseases (varicose veins, vascular atherosclerosis) are predisposed to the chronic course of the inflammatory process. Allergy sufferers, as well as women during pregnancy, are at risk.

In medical practice, there are family cases of erythema nodosum. Of great importance is hereditary predisposition to the development of the pathological process. If parents suffer from the disease, there is a risk of inflammation in the child.

A typical manifestation of the pathology are dense nodes with a diameter of 5 mm to 5 cm, located in the subcutaneous tissue. The inflamed elements are slightly elevated above the edge of the skin, have a red tint. Nodes grow quickly enough to a certain size, then their growth stops. Pain syndrome can have different severity. Most often, patients complain of discomfort during palpation of the inflamed areas. Occasionally, spontaneous pain may occur. Itching is absent in most cases.

Nodes, as a rule, are localized on the anterior surface of the lower leg. However, inflammation can also appear in other areas of the body. Characteristic is the symmetry of the lesion. The nodes in most cases are located on both lower extremities.

Characteristic of the disease is an acute onset. The disease is accompanied by general malaise, fever. Additionally, the following symptoms develop:

chills;
stiffness in the morning;
hand numbness;
pain in the joints;
disorders of the gastrointestinal tract;
swelling and redness of the skin in the joints.

If the therapy is carried out correctly, after 2-3 weeks the nodes resolve, the articular syndrome disappears. In place of the plaques, pink scaly spots remain. A patient in the final stage of the disease may be disturbed by itching. Completely the symptoms of the disease disappear within 25-30 days.

With untimely treatment, erythema nodosum develops into a chronic form. Characteristic are the periods of remissions (symptoms of the inflammatory process are almost completely absent) and exacerbations (there are signs of the disease in an acute form).

For a qualified dermatologist, it will not be difficult to make a correct diagnosis already with a visual examination of the inflamed areas. However, this is not enough to prescribe adequate therapy. It is important to identify the reason for the development of inflammation of the walls of blood vessels. The following methods can be used for this:

General blood analysis. An increase in the number of leukocytes, a change in ESR - all this may indicate the development of an inflammatory process.
Bakposev from the nasopharynx. The study allows you to identify the presence of streptococcal infection in the body.
Tuberculin test. The study is carried out if a patient is suspected of having tuberculosis. For the same purpose, the patient needs to do a chest x-ray.
Blood test for platelets. An increase in the indicator indicates the development of vascular pathology.
Biopsy of one of the nodular formations. The study is carried out in the event that a visual examination makes it difficult to make a diagnosis.

To determine the factor contributing to the development of the inflammatory process, the following diagnostic procedures can additionally be carried out:

rhinoscopy;
pharyngoscopy;
CT scan;
Ultrasound of the veins of the lower extremities.

The patient may need to consult such specialists as a phlebologist, vascular surgeon, oncologist, pulmonologist, infectious disease specialist, etc.

The success of therapy depends on how effectively the pathology that contributes to the development of vascular inflammation was treated. The patient can be prescribed systemic antibiotic therapy, sanitation of chronic foci of infection is carried out. In the acute period, the patient is shown bed rest. In the most difficult cases, the patient is hospitalized. It is necessary to provide rest for the lower extremities. To improve the outflow of blood from the inflamed areas of the leg, it is recommended to fix it in an elevated position.

Drug therapy of the disease includes the use of the following groups of drugs:

Antibiotics. Medicines from this category are prescribed if the inflammation of the vessels is caused by a bacterial infection. Preparations are selected taking into account the sensitivity of pathogenic microflora. Ampicillin, Flemoxin Solutab, etc. can be prescribed.
Non-steroidal anti-inflammatory drugs. These drugs relieve pain, normalize body temperature. Nurofen, Ibuprofen, Diclofenac can be used.
Antihistamines. Medicines from this group help relieve swelling and itching. Good results are shown by Suprastin, Tavegil.
Corticosteroids. Preparations for external use in the form of ointments help relieve unpleasant symptoms. Prednisolone ointment shows good results.
Aminoquinoline derivatives. Medicines from this category are prescribed for the recurrent form of erythema nodosum. Plaquenil, Delagil may be prescribed.

Compresses with Dimexide will help to quickly remove unpleasant symptoms. However, it is impossible to use an anti-inflammatory agent in its pure form, otherwise you can get a burn. It is recommended to dilute Dimexide with clean water in a ratio of 1:3. Keep a medical bandage on the damaged areas should not be more than half an hour. The course of therapy is 10 days.

Physiotherapy treatments

After stopping the acute inflammatory process, when the patient's body temperature returns to normal, the following therapies can be used to speed up the process of restoring damaged areas:

UFO. Ultraviolet rays have a tonic and immunostimulating effect.
Phonophoresis. With the help of ultrasound, drugs are injected into the damaged areas.
Magnetotherapy. Due to the influence of a magnetic field, the regeneration of damaged vessels is accelerated, and blood flow is stimulated.
Laser therapy. Laser radiation has a vasoconstrictive and immunostimulating effect.

In the chronic course of the disease, plasmapheresis shows good results. The procedure is carried out in a hospital setting. The patient's blood is taken, cleaned and returned to the bloodstream. 4-5 procedures are enough to achieve a stable remission.

By agreement with the doctor, conservative therapy can be supplemented with traditional medicine. Many of them show high efficiency. However, they should never be used on their own.

A few fresh aloe leaves must be combined with the juice of half a lemon and a teaspoon of honey. All ingredients must be thoroughly mixed and eaten. This composition has a powerful immunomodulatory effect. However, the recipe is not suitable for people with a tendency to allergies.

A tablespoon of dried arnica flowers must be poured with a glass of boiling water and insisted for at least 12 hours in a dark place under the lid. The resulting product must be filtered and taken 15 ml three times a day.

On the basis of arnica, you can also prepare a healing ointment. Dry rhizomes of the plant must be ground to a powder state (possible in a coffee grinder). Two tablespoons of raw materials must be mixed with 100 g of pork fat. The mixture should be melted over low heat and then simmered for 10-15 minutes. After the agent has cooled, it can be used to treat the affected areas.

To prepare a product that will perfectly stimulate the body's defenses, it is necessary to prepare the following ingredients in advance:

Melissa;
yarrow;
lingonberry leaves;
birch leaves.

All ingredients must be dried, chopped and combined in equal proportions. About 15 g of the mixture must be poured with 500 ml of boiling water and insisted for about an hour. Then the medicine should be filtered and taken 50 ml before meals three times a day.

Dried raw materials must be crushed to a powder state. A tablespoon of the resulting product must be poured with 500 ml of boiling water and boiled for about 15 minutes. Then the product must be filtered and cooled. It is recommended to take 50 ml of this medicine before meals to strengthen the body's defenses.

Plants such as sage, string, chamomile will help quickly relieve inflammation and itching. Herbs can be used individually or mixed. 100 g of dry crushed raw materials must be poured with a liter of boiling water and insisted under a closed lid for about an hour. The finished product must be filtered and used to treat the affected areas.

Forecast and prevention

Erythema nodosum is not a life-threatening disease. With timely adequate therapy, the prognosis is favorable. Completely symptoms disappear within a month.

In children, the pathology is less treatable, therefore mandatory hospitalization is indicated. Women should also seek help immediately when the first symptoms are detected during pregnancy. Pathology of blood vessels can cause complications in the heart.

Refusal of timely therapy will lead to the development of a chronic form of pathology. Violations in the body can lead to the development of other diseases, including focal scleroderma.

We must also not forget that erythema nodosum is often the first evidence of other pathological processes occurring in the body. The sooner an accurate diagnosis is made, the higher the chances of a complete cure.

Prevention of erythema nodosum consists in the timely treatment of any diseases, the elimination of foci of infection in the body. In order not to encounter unpleasant symptoms, it is worth paying enough attention to the immune system:

fully rest;
regularly spend time outdoors;
follow the correct diet.

Erythema nodosum is a disease that requires careful diagnosis. Most often, it is possible to remove unpleasant symptoms by curing the underlying disease. People who carefully monitor their own health rarely encounter pathology.

Erythema nodosum is characterized by inflammation of the connective tissue between the skin and subcutaneous fat. It is also one of the manifestations of allergic vasculitis, in which the vessels are partially affected, often on the lower extremities. The age often affected by the disease is young: 15-30 years. The disease is equally common among both sexes of the population and is especially active during the winter-spring period.

Often this pathology shows itself during the course of pregnancy. The female body during the period of gestation is weakened and loses its strength of resistance to negative influences. Many cases are recorded when the disease is a syndrome of the immune inflammatory process, but the genetic disposition also plays an important role.

Usually it occurs on its own, but it often manifests itself against the background of any pathology. Erythema nodosum can easily be allergic in nature, arising from contraceptives and sulfa drugs.

Among the causes of an infectious nature are in the lead:

tuberculosis bacillus;
streptococcal infection (tonsillitis, scarlet fever);
leprosy;
Hepatitis B;
coccidiosis;
psittacosis;
chlamydia;
syphilis, gonorrhea, etc.;
venereal lymphogranuloma.

From non-infectious emit:

sarcoidosis (most often the cause);
intestinal inflammation (regional enteritis, ulcerative colitis);
Behçet's syndrome;
leukemia;
vaccination;
oncological formations of a different nature;
the use of certain medications;
pregnancy.

The disease has 2 forms.

photo of nodular erythema of the lower extremities

The course of the acute form of annular erythema worsens the general condition: the temperature rises, formations appear in the form of nodes on the shins and knees, rarely in the neck and face. The spots are painful to touch, they are red, turning purple, and then brown and yellow. More than half of patients have joint inflammation.

In children, erythema is severe. The inflammatory process ends by itself after 7 weeks. The chronic course of this disease allows the exacerbation to leave the patient for a short time, but then the nodes move to new areas, that is, they migrate.

When choosing a therapy for effective treatment, physicians differentiate the disease:

toxic - is the norm for the disease, typical for newborns;
multiform develops after colds, nodes affect the oral mucosa, limbs, hands or palms;
migrating speaks of a tick bite, a specific area of \u200b\u200bthe bite is affected;
annular is a chronic form, the occurrence is due to the manifestation of an allergic reaction, poisoning, intoxication, the forms of the nodes merge into rings;
nodular infectious occurs against the background of pathological conditions.

A dermatologist can diagnose erythema nodosum of the lower extremities in the laboratory. In the acute period, a clinical blood test will show neutrophilic leukocytosis. Nasopharyngeal cultures may reveal streptococcus. With pronounced joint syndrome, a visit to a rheumatologist is indicated to check the blood for rheumatoid factor.

To find out the concomitant inflammation of chronic disorders, you may need a study by a pulmonologist, a vascular surgeon, an infectious disease specialist, and you will also have to undergo ultrasound of the veins and rheovasography of the lower extremities.

Effective drugs of various groups:

anti-inflammatory nonsteroidal drugs;
with relapses or a protracted process of inflammation, aminoquinoline drugs are prescribed;
antihistamines and corticosteroids.

If a disease that provoked an immunoinflammatory syndrome is detected, then all forces will go to eliminate it.

The extracorporeal method of plasmapheresis and the effect of a laser on the blood help to quickly reduce symptoms.
Home therapy includes hormonal ointments, compresses with dimexide or ichthyol solution. With puffiness, diuretic herbs will help. Legumes, dill, cumin are added to the diet.
Physiotherapy uses ultraviolet radiation in erythemal doses, magnetotherapy, phonophoresis on the affected area using hydrocortisone.

The effectiveness of any therapy will be influenced by the result of the treatment of the pathology that caused the occurrence of erythema annulare. Great inconvenience for the doctor arises in the treatment of the disease during pregnancy due to the fact that most drugs that can cure the disease are contraindicated.

In difficult cases and in the absence of tuberculosis, glucocorticoid and hormonal drugs are prescribed.

The disease is not dangerous, provided that it is not a companion of another pathology. It can manifest itself long before the underlying disease manifests itself. A complete examination at an early stage of erythema nodosum and identifying its cause will help the right treatment to give a quick and positive result.

In two cases out of ten, a relapse occurs, but there is no threat to life for the patient. The course of the disease does not harm the human body and does not always go into the chronic stage of the disease. Therapeutic prognosis is completely positive in the absence of the presence of pathological forms.

In a child, the clinical picture is almost the same as in adults. But there are still differences. The detection of this disease in children in many cases indicates the presence of tuberculosis in the body. The disease is accompanied by fever, chills and pain in the joints. Nodes appear on the thighs and lower extremities, are swollen and small in size.

If tuberculosis is not detected, the therapy includes aminocaproic acid, reopyrin, calcium gluconate, brufen.

For inflamed foci, Vishnevsky ointment or acemin is used. Vitamins of group B, rutin are added. The dynamics of the disease enters a positive phase during the first week of treatment. In case of relapse, a thorough diagnosis is prescribed for tumors, rheumatism, stomach diseases.

During the period of gestation, many drugs are contraindicated and the treatment process becomes more complicated. Usually stop at treatment without medication, including bed rest and elastic bandages to fix the knots.

In the presence of concomitant pathologies, home isolation will not bring the desired results. If the benefits of unwanted drugs outweigh the risks to the pregnant woman, they are still prescribed in minimal doses.

Taking preventive measures:

closely monitor the vascular system;
if signs of varicose veins appear, undergo an examination;
avoid contact with allergens;
treat chronic diseases.

Let's talk about the treatment of erythema nodosum on the legs. The appearance of characteristic red nodes on the legs is associated with the inflammatory process of the skin. The patient should consult a doctor, since only a specialist can determine the stage of the disease.

Before embarking on the fight against the disease, the doctor must establish the cause that provoked the development of erythema nodosum on the legs. Since any complex treatment always gives the fastest and most effective results, rather than simply removing symptoms.

If the disease was caused by the presence of any infection in the body, then antiviral, antibacterial or antifungal class drugs may be prescribed.

In cases where the patient encounters this disease for the first time, specialists usually prescribe the following drugs:

antihistamines (tavegil, suprastin, cetirizine);
non-steroidal anti-inflammatory drugs (nimesulide, diclofenac);
aminoquinoline drugs and corticosteroids are prescribed for protracted forms of the disease.

Physiotherapy has a fairly effective effect:

magnetotherapy;
laser therapy;
phonophoresis.

In addition, practitioners do not deny the possibility of using traditional medicine, the treatment is carried out locally. Most often, compresses and lotions are used on the affected areas of the body.

Among all known recipes, the following should be highlighted:

herbal decoction of oak bark, black elderberry, raspberry leaves, linden flowers, willow bark and walnut fruits;
a decoction of plantain leaves, mint and birch buds;
ointment from dry arnica root.

The healing process is considered to be the disappearance of red spots and the acquisition of a natural shade of color by the skin.

Causes of the nodular form

Unfortunately, the causal relationship of the appearance of this disease can not always be traced.

But the patient should not hide the presence of the following series of diseases, since in most cases they are provocateurs for the development of erythema nodosum on the lower extremities:

syphilis;
Behcet's disease;
inflammatory process in the intestine;
trichophytosis;
tuberculosis;
Hepatitis B;
gonorrhea;
yersiniosis;
trichophytosis;
blood cancer;
sarcoidosis;
the presence of a bacterial infection.

In addition, the disease can develop on an independent basis in the following situations:

after the use of certain groups of drugs (antibiotics, sulfonamides, oral contraceptives, sulfones);
with severe hypothermia of the human body;
with hypovitaminosis;
in case of failures in the performance of the endocrine system;
when detecting stagnation of fluid in the lower extremities.

People who have at least one of the items from the above list in their lives may consider themselves at risk. So, they must know about this disease and how to deal with it.

One of the most basic symptoms of the manifestation of the disease is the appearance of subcutaneous nodes, which become more dense over time. In places where they appear, the skin becomes red, due to swelling of the tissues, the borders do not have a clearly defined outline. Compacted nodes are quite painful, especially when they are felt.

They can be localized not only in the legs, but also on the buttocks, face and forearm. Lesions can be either single unilateral or symmetrical bilateral.

In addition to the immediate signs of the disease, the patient may experience the following symptoms:

general malaise;
increase in body temperature to subfebrile indicators;
chills;
pain in the joints;
irritability;
headache.

All of the above indicators in the complex indicate the development of erythema nodosum in humans.

Even knowing all the signs of the disease, the patient cannot be completely sure that he has erythema nodosum of the lower extremities, especially when faced with it for the first time. Therefore, you should seek qualified help from a specialist to make an accurate diagnosis and undergo a series of diagnostic procedures.

In general, a dermatologist is involved in the treatment of pathology, but it may be necessary to consult a therapist, pulmonologist, otolaryngologist, rheumatologist, immunologist and other narrower specialists to determine the cause of the disease and conduct a single comprehensive treatment.

If erythema nodosum is suspected, the patient is prescribed a number of diagnostic procedures:

a swab from the pharynx for the presence of streptococcal infection;
biopsy of one of the nodes;
blood test for syphilis;
X-ray of the lungs to confirm or absence of sarcoidosis or tuberculosis;
general blood analysis;
rheovasography of the legs;
analysis of feces for the presence of Yersinia pathogens.

In cases where the cause accompanying the manifestation of the disease cannot be determined, it is considered to have arisen independently.

In cases where an infectious factor is detected, an antibiotic (tetracycline, rifampicin, penicillin or streptomycin) is mandatory.

For best results, antibiotics are combined with corticosteroids (prednisone). The specialist prescribes all dosages on an individual basis, and they must be strictly observed by the patient.

In addition to the above drugs, anti-inflammatory drugs of a general nature are widely used, these include:

nurofen (ibuprofen);
acetylsalicylic acid;
indomethacin;
butadione;
potassium iodide.

Despite the simplest list of drugs, in cases of primary encounter with the disease, it makes sense for the patient to resort to hospitalization.

Since only in this way it is possible not only to strictly control the entire process of the development of the disease, but also to be completely sure that the course treatment is chosen correctly and relapses of the pathology should not be expected in the near future.

Many among patients are wondering what are the most effective means to get rid of this disease forever. Answering this question, I would like to immediately note that there is definitely no suitable medicine for everyone, since its appearance may be associated with a number of other current pathologies.

People suffering from a chronic form of erythema nodosum, and those who first encountered a problem, only need to know that it is necessary to follow all the recommendations of the attending physician and then the disease will definitely recede.

In most cases, people are chasing expensive drugs in the hope that the pathology will disappear forever. But in the modern world, unfortunately, price and quality do not always coincide. Therefore, remember that the patient can get rid of this disease for a penny at current rates.

Among the medicines frequently used by practitioners, the following list of drugs has been particularly effective:

prednisolone;
dimexide;
grass celandine;
amoxiclav;
claritin;
indomethacin.

All these medicines are freely available in pharmacies and are relatively inexpensive. But the dosage and duration of administration should be set only by a qualified specialist.

Since only he, having found out the cause of the appearance of erythema nodosum, can accurately determine the need for taking a particular drug. And the senseless consumption of any kind of medicines has not yet brought additional benefits to anyone.

As noted earlier, practitioners do not deny the possibility of treating this disease with the help of traditional medicine, but any manipulations can be carried out only after agreement with a specialist. Since you can not only not cure, but also aggravate the situation, for example, by provoking an allergic reaction.

Ointment based on arnica rhizome. It will take 100 grams of the dry root of the plant, previously crushed to a powder state, and 150 grams of melted pork internal fat. The ingredients must be shifted in earthenware or enamelware and sent to languish in the oven for 1-1.5 hours. After the time has elapsed, the mixture must be removed and left to cool at room temperature. The prepared ointment should be used externally 3 times a day, lubricating the affected areas of the body. Store the finished product in the refrigerator.
Herbal decoction for lotions. It is necessary to take in equal proportions (50 grams each) raspberry leaves (preferably forest), oak bark, black elderberry, willow bark, linden flowers and walnut fruits. All components of the composition must first be crushed, mixed and placed in an enamel saucepan, pouring 1 liter of boiling water. Put the vessel with the contents on a slow fire and boil for 20 minutes, stirring occasionally. After the lapse of time, the broth is removed from the fire and removed for infusion for 40 minutes at room temperature. It is used topically 2-3 times a day, until the nodes disappear completely.
A decoction of birch buds, mint leaves and plantain. All components are taken pre-dried and crushed in equal proportions of 50 grams. They should be poured with 500 milliliters of boiled water and put in a water bath. From the moment of boiling, the mixture should be kept for ½ hour. Then let cool under normal conditions and strain. Use topically as lotions at least 3 times a day. Course treatment lasts from 14 to 21 calendar days, provided that the patient shows improvement.

Since this disease is directly related to the reduced functionality of the immune system, it makes sense to stimulate its performance through the use of non-traditional medicine:

An infusion of yarrow, immortelle, lingonberry leaves, lemon balm herb and young birch leaves. All components are taken in equal proportions, crushed and thoroughly mixed with each other. From the finished mixture obtained, you should take 15 grams and pour ½ liter of boiling water. Seal the vessel with the contents tightly and remove for infusion for 1 hour, after wrapping it in a warm towel. After the time has elapsed, the infusion should be applied orally 50 milliliters 10 minutes before taking food 3-4 times a day.
A mixture of aloe, honey and lemon. 2 freshly picked leaves of the aloe plant must be passed through a meat grinder or chopped with a blender, add the juice of 1 medium lemon and 2-3 tablespoons of honey to them. Mix all ingredients thoroughly and leave to infuse for 1 hour. The finished mixture is used in 1 tablespoon before each meal. In cases where the drug is prepared for more than one day, then it should be stored in the refrigerator.
Infusion for internal use. In equal quantities, you will need to take chestnut leaves and sweet clover grass. The dry components of the composition are crushed and mixed. 1 tablespoon of the finished mixture is poured with 1 cup of boiling water and removed for infusion for 15 minutes, tightly corked. The finished infusion is filtered and taken 15 milliliters 3-4 times a day 30 minutes before the main meal.

The patient, choosing one of the above recipes for treatment, should remember that if he has an individual intolerance to at least one component from the composition, then it is not worth the risk. You just need to look for another alternative.

Erythema nodosum is a rather insidious disease, despite the fact that even if it is not treated, it will pass on its own within 5-6 calendar weeks.

But in the absence of treatment of its acute form, the pathology very quickly becomes chronic, that is, it can spontaneously arise and fade.

Although, in principle, these are not even the most terrible complications that a person suffering from this pathology may face:

the formation of cosmetic skin defects;
the presence of a number of other more serious diseases, which, most often, are the cause for the presence of erythema;
the appearance of problems of a cardiovascular nature;
during pregnancy, in case of untimely access to the attending physician, instructions can be made to terminate it.

Of course, it seems that there are not so many consequences and complications, but if you evaluate their real weight, it becomes scary. Remember, erythema occurs on its own in extremely rare cases, so the patient, regardless of his age and gender, must undergo all diagnostic measures.

Preventive measures to prevent the occurrence of this pathology should be considered:

monitor the state of the immune system;
undergo scheduled medical examinations;
avoid excessive hypothermia;
do not wear high-heeled shoes often and for a long time;
in cases of the first signs of any disease, do not delay a visit to the doctor;
since the disease most often progresses in the autumn and spring periods, seasonal shoes should be monitored in advance (they should not be too tight, hot and get wet).

The list of preventive measures is quite small, but following it will help each person not come face to face with erythema nodosum of the legs.

This will help:

Erythema nodosum is a variant of allergic vasculitis in which inflammation of the subcutaneous and skin vessels is fixed.

As the disease progresses, the patient develops dense hemispherical nodes. The formations are painful and most often appear symmetrically on the legs.

The development of erythema nodosum in most cases begins in the period of 20-30 years in the winter-spring season.

The occurrence of the disease may be associated with infectious or non-infectious (much less often) diseases. Causes of erythema nodosum on the legs:

Streptococcal inflammations (pharyngitis, yersiniosis, blastomycosis, cytomegalovirus, hepatitis B, chlamydia, psittacosis, Epstein-Barr virus, trichophytosis, lymphogranulomatosis, otitis media, scarlet fever, tonsillitis, cystitis, rheumatoid arthritis, SARS, tuberculosis, histoplasmosis, syphilis, coccidioidomycosis, gonorrhea) .
Allergic reaction to medications (based on bromine, iodine, antibiotics, sulfonamides, contraceptives) and vaccinations.
In the presence of allergies (skin rash, atopic dermatitis, bronchial asthma).
Pathologies of the vascular network (thrombophlebitis, atherosclerosis, varicose veins).
Carrying a child.
genetic predisposition.
Non-communicable diseases (colitis, paraproctitis, Behçet's disease).

Erythema nodosum can result from a minor infection in immunocompromised individuals.

A distinctive feature of the disease is characteristic dense nodules up to 50 mm in circumference. The surface of the skin in the places of formations slightly swells, becomes reddish and smooth.

The nodes grow rapidly, but upon reaching a certain size, their increase stops abruptly. The bulges are painful and this sensation is aggravated by palpation.

After 3-5 days, the nodes become denser and change color, like a bruise: reddish - blue-red - green - yellow. The location is often mirrored: symmetrical on both shins of the legs, sometimes it appears unilaterally or on the calves.

General symptoms:

hyperthermia;
fever;
chills;
general loss of strength, chronic fatigue;
conjunctivitis;
pain in muscle tissue (especially limbs);
aching and not passing pain in the joints.

The duration of the illness is about 1 month. The acute period is up to 3 weeks, then the problem disappears: the nodes peel off and hyperpigmented spots remain in their place. In rare cases, the pathology becomes chronic and sometimes relapses occur.

To establish the diagnosis, an examination and a series of laboratory tests are performed. Such activities are aimed at differentiating pathology, determining concomitant diseases and the causes of occurrence.

Diagnostic methods:

Clinical blood test - detect neutrophilic leukocytosis, elevated ESR.
Bacterial culture from the nasopharynx - to detect streptococcus.
Fecal analysis - to rule out yersiniosis.
With a pronounced pain syndrome in the area of the joints, an additional consultation with a rheumatologist and a blood test for rheumatic tests are prescribed.
Tuberculin diagnostics.
Histological analysis of the node.

If there are difficulties in making a diagnosis, parallel consultations with a pulmonologist, ENT, infectious disease specialist are possible.

The following diagnostic tools are used:

pharyngoscopy;
rhinoscopy;
radiography of the lungs;
Ultrasound and rheovasography of the veins of the lower extremities;
computed tomography of the lungs.

A large arsenal of research is needed to identify concomitant diseases, because erythema nodosum can occur due to such severe pathologies as oncological formations or tuberculosis.

Therapeutic measures depend on the identified root cause of erythema nodosum - initially all funds will be directed to its solution. With an infectious source of occurrence, antifungal, antiviral or antibacterial drugs are prescribed.

For primary erythema nodosum:

Anti-inflammatory drugs (non-steroidal): Diclofenac, Movalis, Nimesulide, Celecoxib.
Corticosteroids (hormonal): Prednisolone, Methylprednisolone. To enhance the action of non-steroidal anti-inflammatory drugs.
Antihistamines: Zodak, Cetirizine, Loratadine, Suprastin, Fenistil, Alerzin.
Aminoquinoline group of drugs (with relapses and protracted course of the disease): Plaquenil, Delagil.
Vitamin therapy.
Immunomodulatory drugs.

As an auxiliary treatment, local application to the nodes of nonsteroidal and corticosteroid ointments, creams, as well as compresses with Dimexide is prescribed.

Physiotherapeutic methods - UV in erythemal doses, phonophoresis with hormonal drugs, laser therapy - are used in treatment and significantly improve the result of treatment.

Rapid regression of symptoms is provided by extracorporeal methods of purification: plasmapheresis, hemosorption, laser blood irradiation.

During treatment, the doctor is obliged to monitor the course of changes in the formed nodes, the therapy lasts until the pathological signs of inflammation in the vessels of the subcutaneous tissue are completely eradicated.

Throughout the treatment of the acute stage of the disease, it is recommended to eat with an increased amount of lactic acid products in the diet and half-bed rest.

Therapy of erythema nodosum on the legs in pediatrics takes place under the strict supervision of physicians due to the need for a large number of control tests and the drugs used.

During the period of bearing a child, the complexity of dealing with the disease becomes much more complicated because most of the recommended drugs threaten the normal development and life of the fetus in the womb.

Erythema nodosum is a self-regressing process, so sometimes they stop at such a drug-free method of treatment as bed rest and fixation with elastic bandages.

But with severe concomitant pathologies, this method is not always applicable, therefore, treatment is prescribed based on the current situation.

After completing the course of treatment, for 2 months it is recommended to limit physical activity on the body, as well as to avoid sudden and significant temperature changes (hot bath, contrast shower, hypothermia in the winter season or overheating in the sun in summer).

Joint pain resolves on its own within 3-6 weeks after the illness.

Erythema nodosum proceeds without significant damage to the human body and is rarely prone to becoming chronic. The danger of the disease is that it often occurs against the background of another, more dangerous pathology.

That is why so many different studies are used for differentiated diagnosis - a carefully conducted examination can detect such serious diseases as sarcoidosis, tuberculosis, and oncological tumors in the early stages. When such pathologies are detected, detection at an early stage is of great importance - the success of treatment and the patient's life in the future depend entirely on this.

Erythema nodosum on the legs is an unpleasant but harmless disease. If there are reddish seals on the legs, you should seek the advice of a rheumatologist. The prognosis in therapy is favorable in the absence of concomitant diseases, erythema is successfully treated both during the period of gestation and in pediatrics.

Erythema is a pathological change in human skin, it becomes knotty and rough, bumps, warts appear on the legs, formations are painful and can change color. The size of the nodules can vary from a small pea to the size of an apple. At first, the knotted cone turns red, then the color changes to purple, at the end it becomes brown or yellowish. Often people do not pay attention to the process, assuming bruises and catch on when time has already been lost.

Coming to the doctor, you will definitely need to undergo an examination with:

dermatologist;
rheumatologist;
therapist.

Having found out the cause of the disease, the nature of the disease, the doctor prescribes treatment. Consider the essence of the disease and its varieties.

The disease is characterized by three main types of diseases:

diverse infectious diseases: tonsillitis, scarlet fever, tuberculosis and others;
non-communicable diseases - sarcoidosis affecting the lungs, lymph nodes, spleen, ulcerative colitis;
multiple allergies.

Features of the disease

The treatment of pregnant women is more difficult, expectant mothers primarily take care of the fetus, they do not want to take potent drugs. For the unborn baby, the disease is not dangerous, but it can adversely affect the health of the mother. The heart takes the brunt of the disease. Doctors recommend bed rest for pregnant women or advise to lie down for preservation. You can not be loaded with problems, carry heavy things. The disease does not disappear completely, it can take a chronic form, worsen in the cold season.

How to treat the disease

Home conditions for the treatment of the disease

Folk methods of treatment

New decoction: grind nettle, take a spoonful of raw materials and pour a liter of boiling water, wait fifteen minutes, pour into a bath, take no more than twenty minutes.

Disease prevention

An inflammatory lesion of the skin and subcutaneous vessels, which has an allergic genesis and is manifested by the formation of dense painful hemispherical inflammatory nodes of various sizes. Most often, the process is localized in the symmetrical areas of the lower extremities. Diagnosis of erythema nodosum is based on data from a dermatological examination, laboratory tests, radiography of the lungs, the conclusion of a pulmonologist, rheumatologist and other specialists. Therapy for erythema nodosum includes the elimination of foci of infection, antibiotic therapy, general and local anti-inflammatory therapy, extracorporeal hemocorrection, the use of ILBI and physiotherapy.

General information

The name "erythema nodosum" was introduced by the British dermatologist Robert Willan in 1807. For a long time, the disease was considered a specific nosological unit. Later, studies were carried out in dermatology that proved that erythema nodosum is one of the variants of allergic vasculitis. In contrast to systemic vasculitis, erythema nodosum is characterized by local vascular lesions, limited mainly to the lower extremities.

Erythema nodosum affects people of any age group, but most often it occurs in patients aged 20-30 years. Before puberty, the prevalence of erythema nodosum is the same among men and women; after puberty, the incidence in women is 3-6 times higher than in men. An increase in cases of erythema nodosum in the winter-spring period is characteristic.

Causes of erythema nodosum

The main cause of sensitization of the body with the development of erythema nodosum are various infectious processes in the body. First of all, these are streptococcal infections (tonsillitis, scarlet fever, acute pharyngitis, streptoderma, erysipelas, otitis media, cystitis, rheumatoid arthritis, etc.) and tuberculosis, less often - yersiniosis, coccidiomycosis, trichophytosis, inguinal lymphogranulomatosis. The disease can also occur due to drug sensitization. The most dangerous drugs in this regard are salicylates, sulfonamides, iodides, bromides, antibiotics and vaccines.

Often, erythema nodosum accompanies sarcoidosis. Rarer non-infectious causes of its development include Behçet's disease, ulcerative colitis, inflammatory bowel disease (Crohn's disease, colitis, paraproctitis), oncological pathology, pregnancy. There are family cases of erythema nodosum associated with a hereditary predisposition to sensitization of the body by infectious or other agents. Patients with vascular disorders (varicose veins, atherosclerosis of the vessels of the lower extremities), allergic diseases (pollinosis, bronchial asthma, atopic dermatitis) or foci of chronic infection (tonsillitis, sinusitis, pyelonephritis) are predisposed to the development of nodular erythema with a chronic course.

Symptoms of erythema nodosum

A typical manifestation of erythema nodosum are dense nodes located in the lower parts of the dermis or in the subcutaneous tissue. The diameter of the nodes varies from 5 mm to 5 cm. The skin above them is smooth and colored red. Elements of erythema nodosum rise above the general level of the skin, their boundaries are blurred due to swelling of the surrounding tissues. By rapidly growing to a certain size, the nodes stop growing. Pain syndrome in patients with erythema nodosum can have different severity and is noted not only during palpation of the nodes, but also spontaneously. Itching is absent. Already after 3-5 days, the resolution of the nodes begins, which is manifested by their compaction and is not accompanied by decay. Characteristic of erythema nodosum is a discoloration of the skin over the nodes, which resembles the process of bruising. Initially red, it becomes brown, and then cyanotic, greenish and yellow.

The most typical localization of nodes in erythema nodosum is the anterior surface of the legs. Symmetry of defeat is more often observed, but the unilateral or single character of rashes is possible. Elements of erythema nodosum can occur wherever there is subcutaneous fat: on the thighs, calves, buttocks, forearms, face, and even the episclera of the eyeball.

In most cases, erythema nodosum has an acute onset and is accompanied by fever, anorexia, general malaise, and chills. Approximately 2/3 of patients have arthropathies: joint pain (arthralgia), pain on palpation, stiffness in the morning. In 1/3 of patients with erythema nodosum, subjective symptoms are accompanied by objective signs of inflammation in the joint (arthritis): swelling and redness of the skin in the joint area, an increase in local temperature, and the presence of intra-articular effusion. The articular syndrome in erythema nodosum is characterized by a symmetrical lesion of large joints. Swelling of the small joints of the feet and hands is possible. General symptoms and arthropathies may precede the appearance of skin elements by several days.

As a rule, within 2-3 weeks there is a complete resolution of the nodes of erythema nodosum. In their place, temporary hyperpigmentation and peeling may occur. Simultaneously with the skin symptoms, the articular syndrome also disappears. In total, the acute form of erythema nodosum lasts about 1 month.

Much less often, erythema nodosum has a stubbornly relapsing chronic course. Exacerbations of the disease are manifested by the appearance of a small number of single bluish-pink nodes of dense consistency, which persist for several months. Skin manifestations may be accompanied by chronic arthropathy, which occurs without deformity of the joints.

Diagnosis of erythema nodosum

Changes in laboratory data in erythema nodosum are nonspecific. However, they allow to differentiate the disease from other disorders, to identify its cause and concomitant pathology. In the clinical analysis of blood in the acute period or with recurrence of chronic erythema nodosum, neutrophilic leukocytosis and elevated ESR are observed. Cultures from the nasopharynx often reveal the presence of a streptococcal infection. If yersiniosis is suspected, stool culture is performed, and tuberculin diagnostics is performed to exclude tuberculosis. Severe articular syndrome is an indication for a consultation with a rheumatologist and a blood test for rheumatoid factor.

In difficult cases, to confirm the diagnosis of erythema nodosum, a dermatologist prescribes a biopsy of one of the nodular formations. Histological study of the obtained material reveals the presence of an inflammatory process in the walls of small arteries and veins, in the interlobular septa at the border of the dermis and subcutaneous tissue.

Determination of the etiological factor of erythema nodosum, concomitant foci of chronic infection or vascular disorders may require consultation with a pulmonologist,

To date, diseases such as erythema nodosum are not so common, but they bring a lot of psychological and physical discomfort. Such pathologies have a complex origin and require a comprehensive diagnosis of the body. In the early stages of the lesion, unpleasant manifestations can be reduced to nothing.

What is a disease

Erythema nodosum, or as it is also called erythema nodosum, is an etiologically complex disease that affects the vessels mainly of the upper and lower extremities. In this case, inflammation and the formation of specific subcutaneous nodes are observed. For a long time, the origin of the pathology was not studied. However, at the moment it was possible to find out the allergic etiology of the inflammatory process in the vessels.

The disease is rare in children. It is mainly distributed among people from 20 to 30 years old. Moreover, in women, pathology occurs more often than in men. The risk of exacerbations occurs in winter and spring.

Types of erythema nodosum

Most often, the pathology occurs on the arms and legs. At the same time, red spots are clearly visible on the skin, indicating an inflammatory process. If we talk about the lower extremities, then the hips, shins and knees can be affected. When a disease occurs on the hands, the hands, elbows, and forearms are involved in the process.

There are the following main forms of the disease:

Acute. It has an unexpected onset and proceeds with the manifestation of acute and constantly growing symptoms.
Chronic. It is subdivided into 2 types:
- migratory - characterized by dense nodules and bluish color of the skin;
- superficial infiltrative - manifested by severe pain, swelling and swelling of the joints.
Secondary acute. Occurs during exacerbation of a long-term chronic process. It is characterized by large and dense infiltrates.

Causes of pathology

The main provoking factor of the disease is the sensitization of the body, in which there is a pathological reaction to any extraneous irritant. The causes of the development of erythema nodosum are:

severe form of angina;
lymphomas;
streptoderma;
autoimmune diseases of the joints;
cystitis;
tuberculosis;
scarlet fever;
ulcerative colitis.

In addition, the provoking factor in the occurrence of such an ailment may be the intake of certain types of drugs, such as broad-spectrum antibiotics, iodides and various vaccines.

Symptoms and signs of the disease

Erythema nodosum is characterized by the presence of a certain group of symptoms, the main of which are:

numbness in the limbs;
deterioration in general well-being;
a slight increase in temperature;
the appearance of painful nodes that have a reddish tint;
inflammation of the joints;
itching of the skin;
edema.

In a more severe form, the pathology manifests itself in children. Reddish dense nodes gradually change color to purple, then to yellowish. In a chronic course, seals often merge into one large painful spot. After one area has healed, a knot may appear in another area.

Diagnostic methods

The diagnosis is determined by clinical manifestations, but other studies are also needed to determine the causative factors in the development of the disease.

Diagnosis of the disease - table

Diagnostic method	Characteristic	What cause can be identified
General blood analysis	The analysis allows you to determine the number of platelets and leukocytes. With an increase in the level of the former, one can judge about accelerated blood clotting, which can provoke the progress of the disease. An upward change in the number of leukocytes indicates the presence of an inflammatory process, which may be present in a number of infectious diseases. The same can be suspected with an increase in the erythrocyte sedimentation rate.	Infectious diseases and increased blood clotting.
Sowing a smear from the pharynx and tonsils	Manipulation is carried out using a special thin spatula. A small scraping is made from the mucous membrane of the larynx and the contents are applied to a glass slide for further examination under a microscope.	Streptococcal and staphylococcal infections.
Fluorography	An x-ray is used to diagnose the condition of the lungs and the presence of characteristic changes in them.	Tuberculosis
Examination by a dermatologist	The specialist immediately determines the presence of a nodular form of erythema during a visual examination.	Other forms of skin reactions.
Blood test for rheumatoid factor	The presence of antibodies in the blood allows you to identify the aggressive impact of your own defenses on the joints and tissues.	Autoimmune arthritis.
Gastroenterologist consultation	The specialist diagnoses the state of the gastrointestinal tract and, by the presence of certain complaints, can identify additional causes. For diagnosis, an endoscopic examination of the stomach and intestines is prescribed.	Ulcerative colitis.

Treatment

Drug treatment of erythema nodosum should first of all be aimed at eliminating the cause of the disease. The following groups of drugs are most often used:

Non-steroidal anti-inflammatory drugs: Indomethacin, Nimesil, Ibuprofen. NSAIDs can reduce the severity of the inflammatory process, pain and other symptoms. In this case, drugs can be used both inside in tablet form and externally in the form of ointments. This line of drugs reduces the severity of the main manifestations, but does not eliminate the provoking factor.
Glucocorticosteroids: Prednisolone, Glucocortisone. They allow you to get rid of itching and pain, reducing the severity of the nodes and preventing their further progress. The drugs have a systemic effect on the body and have a lot of side effects, so they are used only with the permission of a doctor.
Antihistamines: Desal, Suprastin. They relieve severe symptoms and prevent the progression of skin manifestations.
Antibiotics. The type of drug depends on the source of infection and its pathogen. This group of drugs allows you to eliminate the bacteria that are present in the chronic focus and provoke the development of hypersensitivity of the body to any kind of irritant. With staphylococcal infection, which occurs most often, tetracycline, erythromycin and other antibiotics are used.

Medical treatment - gallery

Ibuprofen is a non-steroidal anti-inflammatory drug
Prednisolone is a glucocorticosteroid drug
Suprastin - an effective remedy for allergies
Tetracycline is a broad spectrum antibiotic

Physiotherapy methods

With this kind of pathology, the following types of physiotherapy are most often used:

UVR is a method based on irradiating the causative zone with ultraviolet light. Penetrating to a shallow depth, UV rays have a pronounced effect - they relieve inflammation, reduce the size of the nodes, lowering the pathological reaction of the body and strengthening the immune system.
Magnetotherapy is an effective and gentle way of physiotherapy. This method is based on the effect of a magnetic field on the human body. This improves the general condition of the vessels and accelerates blood circulation.
Laser therapy - eliminates pain, relieves inflammation and stimulates the immune system, destroying bacterial foci. This method is based on the use of a low-frequency laser.
Phonophoresis is a method in which a medicinal substance and ultrasound are used to promote deep penetration of active ingredients. With erythema nodosum, preference is given to phonophoresis with hydrocortisone.

Folk methods of treatment

Traditional medicine methods for such a disease are used only as a general strengthening therapy, as well as to eliminate edema, which often accompanies erythema nodosum. Basic recipes:

Diuretic cocktail. You will need cranberry juice, viburnum and rowan juice. All of the listed ingredients must be taken in equal proportions of 100 ml. Mix and take an hour after the main meal, a glass 2 times a day for a week. It is necessary to monitor the reaction of the body so as not to provoke an increase in allergies. In most cases, this recipe allows you to quickly get rid of excess fluid in the body and prevent its accumulation in the tissues.
Herbal infusion for edema. You will need to take bearberry, licorice and St. John's wort in equal proportions in the amount of 1 tsp. Then pour 300 ml of boiling water and let it brew for half an hour. After that, the liquid must be filtered and taken 100 ml 2-3 times a day 30 minutes before meals for 10 days.
Immunostimulating decoction. You will need rose hips, oregano and St. John's wort grass. First of all, prepare a small saucepan. There put 1 tbsp. l. rose hips and 1 tsp. listed herbs. Then pour 500 ml of warm water and boil for 5-7 minutes. After that, let the liquid cool down. Before use, the decoction must be filtered and taken 2 times a day, morning and evening, 20 minutes before meals. The course of treatment is 2 weeks.

Folk methods of treatment - gallery

Cranberry juice has a diuretic effect
Viburnum juice strengthens the immune system
Rowan juice accelerates the excretion of fluid
Bearberry stimulates urination
Licorice has an anti-inflammatory effect
St. John's wort strengthens the immune system
Oregano regulates the digestive tract
Rosehip - a source of vitamin C

Treatment prognosis and possible complications

The acute form of the disease lasts from 1 to 1.5 months. It all depends on the state of the body and the cause that provoked the disease. Rarely, the pathology has a longer course in a chronic form. The prognosis of treatment for erythema nodosum is good, provided that the cause of the disease, which may pose a threat, is diagnosed at an early stage. The disease itself is not dangerous for its complications.

So, tuberculosis, detected at an advanced stage, can lead to death. Autoimmune pathologies significantly complicate the life of every person, affecting not only the vessels, but also the joints and organs of the gastrointestinal tract. Chronic foci of infection pose a potential danger to the cardiovascular system, and can also provoke an increase in symptoms.

Erythema may be the initial manifestation of scleroderma, a serious disease in which connective tissue is damaged. Therefore, treatment should not be delayed.

Prevention

Methods of disease prevention are aimed at early diagnosis of the underlying disease. For these purposes, at the first signs of skin manifestations, as well as problems with other organs and systems, you should immediately consult a doctor. A cough that occurs for no apparent reason, as well as constant sore throat, chronic sore throat, stool disorders and general unsatisfactory well-being, should be alarming.

Prevention is also aimed at stimulating the immune system. To do this, you need to be outdoors more often, eat more fresh vegetables and fruits, engage in physical activity and avoid a sedentary lifestyle. Hardening and contrast dousing in the summer stimulate their own immune defenses.

If incomprehensible red spots appear on the skin, which increase in size and are slightly compacted, then you should immediately consult a doctor. Rapidly growing symptoms are especially dangerous.

Features in children

In childhood, the disease is much more severe than in adults. The child may have a fever, loss of appetite, and skin manifestations itch and cause severe discomfort. Most children become restless and sleep poorly. At an early age, erythema nodosum is prone to migration. When the seal disappears in one place, it may appear in another.

Erythema nodosum in a child requires special attention

The occurrence of pathology in childhood should alert parents, because the cause can be dangerous for the health of the child and in the future will provoke dangerous consequences. In addition, children with erythema nodosum cannot lead their usual lifestyle, and hospital treatment is often required.

Description of erythema nodosum

Most often, pathology is faced by young people aged 20-30 years. Statistics show that women develop the disease more often. Exacerbation in most cases occurs in the winter-spring period.

Classification

Depending on the causes of the disease, the following types are distinguished:

Infectious erythema. The disease develops against the background of various infections in patients of any age.
Multiform exudative erythema. The disease develops against the background of a cold, may be accompanied by pain in the throat, joints. Nodes are formed not only on the limbs, but also on the oral mucosa, in the genital area.
Annular erythema. The disease is classified as chronic. Pathology can develop against the background of allergic reactions, a prolonged illness of an infectious nature. Round nodules eventually merge into rings.
migratory erythema. Pathology is manifested due to a tick bite.

Toxic erythema is a disease that develops in a child in the first days of life. Small red seals appear on the baby's body. After a few days, the rash goes away on its own. No special treatment is required.

Causes of the pathological process on the legs and arms

angina;
cystitis;
streptoderma;
tuberculosis;
rheumatoid arthritis;
scarlet fever, etc.

Nodules on the skin can develop as a side effect of drug therapy. Often, erythema nodosum appears after vaccination or antibiotics.

People suffering from oncological pathologies also have to deal with inflammation of the vascular walls. People with lymphoma are most susceptible to erythema nodosum. People with diseases of the blood and blood vessels (varicose veins, blood vessels) are predisposed to the chronic course of the inflammatory process. Allergy sufferers, as well as women during pregnancy, are at risk.

In medical practice, there are family cases of erythema nodosum. Of great importance is hereditary predisposition to the development of the pathological process. If parents suffer from the disease, there is a risk of inflammation in the child.

Symptoms of the disease

Characteristic of the disease is an acute onset. The disease is accompanied by general malaise, fever. Additionally, the following symptoms develop:

chills;
stiffness in the morning;
hand numbness;
pain in the joints;
disorders of the gastrointestinal tract;
swelling and redness of the skin in the joints.

Diagnostics

General blood analysis. An increase in the number of leukocytes, a change - all this may indicate the development of an inflammatory process.
Bakposev from the nasopharynx. The study allows you to identify the presence of streptococcal infection in the body.
Tuberculin test. The study is carried out if a patient is suspected of having tuberculosis. For the same purpose, the patient needs to do a chest x-ray.
Blood test for platelets. An increase in the indicator indicates the development of vascular pathology.
Biopsy of one of the nodular formations. The study is carried out in the event that a visual examination makes it difficult to make a diagnosis.

To determine the factor contributing to the development of the inflammatory process, the following diagnostic procedures can additionally be carried out:

rhinoscopy;
pharyngoscopy;
CT scan;
Ultrasound of the veins of the lower extremities.

The patient may need to consult such specialists as a phlebologist, vascular surgeon, oncologist, pulmonologist, infectious disease specialist, etc.

Treatment: medications, medications used

Drug therapy of the disease includes the use of the following groups of drugs:

Antibiotics. Medicines from this category are prescribed if the inflammation of the vessels is caused by a bacterial infection. Preparations are selected taking into account the sensitivity of pathogenic microflora. Ampicillin, Flemoxin Solutab, etc. can be prescribed.
Non-steroidal anti-inflammatory drugs. These drugs relieve pain, normalize body temperature. Nurofen, Ibuprofen, Diclofenac can be used.
Antihistamines. Medicines from this group help relieve swelling and itching. Good results are shown by Suprastin, Tavegil.
Corticosteroids. Preparations for external use in the form of ointments help relieve unpleasant symptoms. Prednisolone ointment shows good results.
Aminoquinoline derivatives. Medicines from this category are prescribed for the recurrent form of erythema nodosum. Plaquenil, Delagil may be prescribed.

Compresses with Dimexide will help to quickly remove unpleasant symptoms. However, it is impossible to use an anti-inflammatory agent in its pure form, otherwise you can get a burn. It is recommended to dilute Dimexide with clean water in a ratio of 1:3. Keep a medical bandage on the damaged areas should not be more than half an hour. The course of therapy is 10 days.

Medicines for erythema nodosum - gallery

Prednisolone - an anti-inflammatory agent for external use Flemoxin solutab - a broad-spectrum antibiotic Diclofenac normalizes the patient's well-being, relieves inflammation Tavegil relieves swelling

Physiotherapy treatments

After stopping the acute inflammatory process, when the patient's body temperature returns to normal, the following therapies can be used to speed up the process of restoring damaged areas:

UFO. Ultraviolet rays have a tonic and immunostimulating effect.
Phonophoresis. With the help of ultrasound, drugs are injected into the damaged areas.
Magnetotherapy. Due to the influence of a magnetic field, the regeneration of damaged vessels is accelerated, and blood flow is stimulated.
Laser therapy. Laser radiation has a vasoconstrictive and immunostimulating effect.

Alternative methods of treatment of erythema nodosum

By agreement with the doctor, conservative therapy can be supplemented with traditional medicine. Many of them show high efficiency. However, they should never be used on their own.

Aloe and honey

Arnica

Healing infusion

To prepare a product that will perfectly stimulate the body's defenses, it is necessary to prepare the following ingredients in advance:

Melissa;
yarrow;
lingonberry leaves;
birch leaves.

white willow bark

Medicinal herbs for external use

Folk medicine recipes - gallery

Forecast and prevention

Erythema nodosum is not a life-threatening disease. With timely adequate therapy, the prognosis is favorable. Completely symptoms disappear within a month.

Refusal of timely therapy will lead to the development of a chronic form of pathology. Violations in the body can lead to the development of other diseases, including focal scleroderma.

fully rest;
regularly spend time outdoors;
follow the correct diet.

Erythema nodosum: causes and treatment methods. Causes and treatment of erythema nodosum of the legs Erythema nodosum on the legs causes and treatment

Symptoms

Folk methods of treatment

Physiotherapy treatments

Forecast and prevention

Causes of the nodular form

Features of the disease

How to treat the disease

Home conditions for the treatment of the disease

Folk methods of treatment

Disease prevention

General information

Causes of erythema nodosum

Symptoms of erythema nodosum

Diagnosis of erythema nodosum

What is a disease

Types of erythema nodosum

Causes of pathology

Symptoms and signs of the disease

Diagnostic methods

Diagnosis of the disease - table

Treatment

Medical treatment - gallery

Physiotherapy methods

Folk methods of treatment

Folk methods of treatment - gallery

Treatment prognosis and possible complications

Prevention

Features in children

Description of erythema nodosum

Classification

Causes of the pathological process on the legs and arms

Symptoms of the disease

Diagnostics

Treatment: medications, medications used

Medicines for erythema nodosum - gallery

Physiotherapy treatments

Alternative methods of treatment of erythema nodosum

Aloe and honey

Arnica

Healing infusion

white willow bark

Medicinal herbs for external use

Folk medicine recipes - gallery

Forecast and prevention

Video about the disease