-- --- ---- ----- ------ ------- -------- --------- ------------ ------------- --------------- ----------------- ------------------- --------------------------------------------------------------------------- 30 yr young lady presents to the ED with painful leg lesions The cause of these lesions have a generic / umbrella term. What's the term and the various etiologies / differentials that could explain this lesion ?
Answer: Erythema Nodosum Discussion The picture is consistent with erythema nodosum. These are smooth, shiny, red, tender inflammatory nodules that usually appear on the anterior tibia. They result from a hypersensitivity reaction to the subcutaneous fat causing panniculitis. Erythema nodosum may be precipitated by drugs, systemic illness, or infection. Drugs that lead to erythema nodosum include oral contraceptive pills and sulfa-containing medications. Common infectious etiologies include Streptococcus, Mycoplasma, Epstein-Barr virus, tuberculosis, and fungal infections; although autoimmune etiologies include inflammatory bowel disease (IBD) and Behcets. Most patients are idiopathic or secondary to a recent streptococcal infection. Treatment is supportive and includes NSAIDs, compressive leg dressings, and elevation of the effected extremity. Corticosteroids are not recommended as they may exacerbate underlying TB, lymphoma, or mycoses. ref: Intensive review for the emergency medicine qualifying exam & Fitzpatrick's Color Atlas and Synopsis of Clinical Dermatology, 5th ed
