How is erythema nodosum treated?

Erythema nodosum is an acute inflammatory disease that often occurs in middle-aged and young women. Generally speaking, it is believed that the disease is related to many factors. Erythema nodosum is common on the inner side of the calf. Clinically, it manifests as red or purple painful inflammatory nodules. The course of the disease is limited and it is very easy to relapse. Therefore, erythema nodosum has always troubled patients. So we must find a treatment method. So, how to treat erythema nodosum?

There is a history of infection or medication before the onset of the disease. The skin lesions occur suddenly and are bilaterally symmetrical subcutaneous nodules, ranging in size from broad beans to walnuts, with a number of 10 or more, and are painful or tender to the touch, with medium hardness. In the early stage, the skin color is light pink, the surface is smooth and slightly raised. After a few days, the skin color turns dark red or bluish red and the surface becomes flat. After 3 to 4 weeks, the nodules gradually disappear, leaving temporary pigmentation, and the nodules never ulcerate. The lesions often occur on the anterior tibia, but can also be seen on the thighs, extensor side of the upper arms and neck, and are rarely seen on the face.

Chronic nodosum erythema has characteristics different from those of acute nodosum erythema. It often occurs in elderly women. The lesions are unilateral. If they are bilateral, they are asymmetrical. Except for joint pain, there are no other systemic symptoms. The nodules are not painful and are softer than those in acute erythema nodosum.

1. Systemic treatment

(1) Find the cause and provide appropriate treatment. During the acute phase, you can rest in bed, elevate the affected limb, and avoid cold and strenuous labor. For those with obvious infection foci, antibiotics can be used in combination.

(2) For patients with more severe pain, oral analgesics and non-steroidal anti-inflammatory drugs, such as indomethacin (Indomethacin) and ibuprofen, can be taken. For those with obvious infection, give antibiotics. In severe cases, corticosteroids, such as prednisone (Kedison) or betamethasone/betamethasone dipropionate (Diprosone), can be given by intramuscular injection once every 3 weeks to quickly control the disease. In addition, 10% potassium iodide mixture can be used, 3 times a day, for 2 to 4 weeks. This method is safe and effective, but it should be noted that long-term use may lead to hypothyroidism. For patients with stubborn illness, hydroxychloroquine and dapsone can be used, or the Chinese medicine Tripterygium wilfordii tablets or Kunming Shanhaisu tablets can be taken. Systemic treatment can also be done with ultraviolet light, wax therapy, diathermy or audio-frequency electrotherapy.

2. Local treatment

The principles of local treatment are anti-inflammatory and analgesic. For external use, fish boron ointment, 10% camphor ointment or 75% alcohol local wet compress can be used. In addition, corticosteroid ointment can be applied externally to relieve pain. You can also inject about 0.3 ml of triamcinolone suspension added to 2% procaine solution into the skin lesions, which has a significant effect on those with persistent and severe pain in the nodules.

Different types of patients have different precautions and suitable foods. But overall, it's similar. Patients should not eat foods such as sweet, fatty, greasy, spicy and greasy foods, fried foods, pickled foods, lamb, dog meat, oranges and longans, etc., which provide high-calorie foods, and do not drink black tea.