• Wednesday April 8,2020

Erythema nodosum

Erythema nodosum is a skin inflammatory disease that leads to soft, nodular and painful inflammatory reactions in the subcutaneous fat tissue. The knot rose occurs on the front sides of the lower legs. Mainly women are affected by an erythema nodosum. A knot is often confused with a wound rose by doctors and treated incorrectly because of similar symptoms and symptoms.

What is erythema nodosum?

An erythema nodosum manifests itself through the characteristic nodules in the subcutaneous fatty tissue. The growths are very painful, blurred limited and felt from the outside.
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In an erythema nodosum occur on the lower legs - rarely on other parts of the body such as the buttocks - several nodular sites of inflammation. They can vary in size and merge depending on the severity of the knot.

The inflammation affects the subcutaneous fatty tissue. For various causes, which include not only a bacterial infection but also allergies, hormone fluctuations or infected injuries, the tissue is inflamed. Erythema nodosum is a very painful condition, but in many cases heals spontaneously without any treatment.

At first, there are still skin changes that resemble healing hematomas. It is possible that erythema nodosum develops into a chronic disease triggered by another underlying disease. Knotrose, however, also appears as an isolated disease.


Erythema nodosum has a number of very different causes. Ostensibly there is an inflammation of the skin. The trigger for this, however, in the node rose from a bacterial infection in a completely different area of ​​the body to an isolated outbreak without further triggers.

Apart from the isolated knot, it can be assumed that the skin reacts to another impairment of the body through the inflammation. Erythema nodosum is commonly associated with tonsillitis or bowel inflammation. Also, an allergic reaction or hormonal fluctuations by taking the birth control pill and pregnancy lead to the appearance of erythema nodosum.

For the characterization as an overreaction, it is pointed out that in most cases the nodular rose also heals smoothly.

Symptoms, complaints & signs

An erythema nodosum manifests itself through the characteristic nodules in the subcutaneous fatty tissue. The growths are very painful, blurred limited and felt from the outside. They reach a size of several centimeters and can become a larger node as the disease progresses.

The surrounding tissue is reddened and overheated, when merging multiple growths it often takes on a dark red color and is very sensitive to pressure. The color of the nodes changes in the course of the disease from a reddish-purple tone to a yellowish-green color. The inflammatory nodules occur predominantly on both lower legs, especially in the area of ​​shin splints and hocks.

In severe cases, additional nodes on knees, thighs, arms and elbows form. Accompanying the external features, an erythema nodosum expresses itself by an increasing malaise. Those affected often feel knocked off and tired, and suffer from fever or joint and muscle pain.

In the later stages circulatory problems such as sweating or palpitations can be added. If the nodes are scratched, an infection can develop. Thanks to the conspicuous signs and symptoms, a knot can be quickly diagnosed and then treated in a targeted manner.

Diagnosis & History

Erythema nodosum is unproblematic because of its typical nodularity, reddened skin, and the usually limited incidence on the front of the lower leg.

For clarification of another underlying disease, infections such as tonsillitis or intestinal diseases are inquired and, if in doubt, more accurately diagnosed if the symptoms are unclear. A possible pregnancy should already be clarified because of the drug treatment of erythema nodosum.

The nodule usually develops within a few days and then lasts for a period of two to three weeks. Finally, the symptoms resolve again and leave behind hematomas as a consequence of dermatitis. During this period, a patient may feel choppy and feverish. It tires easily and is less powerful through the knot-rose.

The painful lesions of the erythema nodosum affect the ability to move and generally cause a physical and mental weakening.


The erythema nodosum also called knot-rose, belongs to the inflammatory skin diseases, which often affect women. In the subcutaneous fatty tissue of the lower leg front sides arise soft nodes, which are visibly reddened. If the affected parts swell, they begin to hurt badly. The symptom is often confused with the Wundrose. Patients should therefore consult the doctor at the first sign.

Disease trigger can be a bacterial infection or an isolated outbreak, whereby the skin reacts by inflammation to an endogenous concomitant. These include intestinal diseases, allergies, hormone fluctuations, oral contraceptives, tonsillitis and pregnancy. In most cases, there are few complications, but the symptom may develop chronically if there is another underlying disease or overreaction.

If an erythema nodosum is not treated in time, not only the triggering cause worsens. The extremely pressure-sensitive knots can swell below the skin surface down to palm size and cause hematomas as well as severe reddening of the skin. The legs hurt, feel overheated, bloated and heavy.

Some sufferers experience fever and a significant drop in performance. The medical countermeasures let the knotty decay with early detection in about three weeks relatively complication-free and treat at the same time the causative disease or infection. If the therapy is based on cortisone, the pregnancy should be ruled out beforehand.

When should you go to the doctor?

Forming on the Skin Knots that are considered painful or uncomfortable should be consulted by a doctor. If the symptoms persist or occur repeatedly, it is advisable to consult a doctor. If symptoms of inflammation occur, a doctor's visit should also be made.

In the formation of pus and the emergence of open wounds germs can enter the organism, which lead to further diseases. Since severe cases of blood poisoning threatens, a doctor should be consulted as soon as a discomfort or increased body temperature set. If body fluids leak out of the nodes, this is considered unusual and should be clarified.

If the size and size of the lumps increase, a doctor should be contacted. If emotional or mental problems occur, a doctor is needed. Persistent mood swings, a depressed state of mind or a social withdrawal are considered to be alarming and should be discussed with a physician. If the person suffering from pain, swelling or joint problems, he needs a doctor.

If it comes due to the symptoms to a reduced movement or incorrect posture, a visit to a doctor is necessary. It threatens permanent damage, which should be prevented in time. With a feeling of permanent heat on the affected regions, it is advisable to consult a doctor.

Treatment & Therapy

Treatment is not mandatory for erythema nodosum, but should still be done because of the considerable pain. Erythema nodosum usually responds well to anti-inflammatory drugs.

For faster healing of the skin changes, the use of a cortisone-containing ointment in the external application is helpful. The oral administration of cortisone preparations can shorten the course of the disease. Antibiotics are used when the underlying disease is a bacterial infection such as tonsillitis. If it heals, the knot also improves in direct connection.

Since erythema nodosum affects the lower legs, it is necessary to avoid any excessive leg strain during the illness. Patients with nodule feel garments that cover their lower legs as painful. The areas are hot due to inflammation and do not require any additional load due to bandages or tight-fitting garments.

Only when the symptoms have resolved can an elastic bandage be created for an erythema nodosum. This promotes the regression of the hemotome and protects against unwanted pressure pain in the decay phase of the knot.

Outlook & Forecast

The prognosis of the erythema nodosum is favorable. In a large number of those affected no therapy is necessary. Changes in the appearance of the skin heal spontaneously and without the need for treatment. Within a few days, an improvement usually occurs, until after a few weeks a complete complaint-free status is achieved. For symptoms such as pain, medicines are used to relieve symptoms. They support the healing process and lead to an improvement in health. In addition, ointments are administered, which promote a regression of the skin lesions.

Patients with a weakened immune system should undergo a good prognosis for medical treatment. There is a risk that the pathogens spread and existing complaints increase. In addition, the organism is often unable, without support, to prevent and kill the bacteria with their own forces. Help should be sought so that there is no further deterioration of the state of health and thus a worsening of the prognosis.

If complications occur, this can lead to impairment of the healing prospects. The mobility is limited for the duration of the disease. Emotional problems can occur, which in severe cases lead to mental disorders. If this course is clear, unwanted delays can occur.


Erythema nodosum as a spontaneous overreaction to another underlying disease is hard to prevent. This is different for patients who respond to contact with an allergen with a nodular rose. If the causative factor of erythema nodosum is known, it should be avoided for the future.


In the case of erythema nodosum, the affected person has in most cases very few measures and options for follow-up care. In the case of this disease, first of all an early detection with the subsequent treatment must be carried out. Only in this way can further complications or complaints be prevented, as this disease can not lead to self-healing.

Erythema nodosum therefore focuses on the early detection of the disease. The sooner it is recognized, the better the disease progression will usually be. The treatment itself usually takes place by taking medication, whereby antibiotics are also used. The person concerned should pay attention to a regular intake and also to a correct dose when taking.

In this case, antibiotics should not be taken together with alcohol, as their effect is otherwise significantly weakened. Furthermore, regular examinations by a doctor are very important to detect other complaints early. As a rule, the antibiotics should continue to be taken for a while even after the symptoms subsided. As a rule, the life expectancy of the person affected by this disease is not reduced.

You can do that yourself

An erythema nodosum generally heals without therapy within three to six weeks. However, the knot can cause severe pain that needs to be treated with various medications. Sometimes natural remedies, such as marigold ointment or arnica, also help.

Parallel to the symptomatic treatment, it is important to determine the causative disease and to treat it. Affected individuals can best make a complaint journal that notes the nature and intensity of the symptoms. This makes it easier for the doctor to diagnose the underlying condition. If the birth control pill is the cause of erythema nodosum, it should be changed to another product in consultation with the gynecologist. Also, the three-month syringe and the hormone spiral are possible triggers that must be discontinued in the event of a nodule.

Painful lumps in the subcutaneous fatty tissue may require surgery. The doctor will decide after a comprehensive examination and tell the patient what preparatory measures he must take. Basically, before and after an operation, protection and stress avoidance apply. A balanced diet can promote recovery and also relieve the acute symptoms of erythema nodosum.

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