Erythema nodosum

erythema nodosum

From others' experiences, does return of erythema always indicate a flare?

Today i noticed an erthyma lump on my leg
In terms of other crohn's symptoms - I've been getting a bit more diarhea than normal and have noticed a lot more stomach noises (grumbling etc)
I do have a cold at the moment - so my immune system is a bit out of whack
but otherwise, I haven't had much pain.. im just worried because i had erthyma for over 4 years .

.. thoughts?

I don't have any advice regarding erythema, but I hope it isn't a sign of a flare coming on. Keep a close eye on your symptoms, and don't delay in phoning your GI if you do in fact think a flare is starting. Better to be proactive before it gets worse!

I hope you feel better soon!

For me, I think it does. I had a re-occurrence of my Erythema a few months back now and my Gastro doctor put me back on the steroids, which immediately cleared it.

Well what do you know! I have it on the top of my right foot in a circle. Doc did a biopsy on in before I was diagnosed with Crohn's. I never considered it as a symptom. Just an FYI, but it went away as soon as I started Prednisone. It's still gone with the Humira.

i get the skin rash on the bottom of my belly... they kinda look like skin bullet hole insect bites that get bigger... they hurt and i wore jeans when i didnt notice them and they got irritated ouch...

I'm on Humira only now because of a bad reaction to 6MP. When they were taking me off the 6MP the darn rash came back, hitting the tops of my fingers. So painful. They lasted a few days then disappeared. I'd prefer they stay gone forever. They really are painful. Mine are round, squishy to hard, bright red, and painful to the touch.

HI,

I have had erythema nodosme twice ...and it was not fun...the first time it covered noth my legs from the knee down.. The last time i had it was a few months ago when I was in a crohns flare..just one bump, above the ankle..it got huge..painful...couldnt walk..thought i would need crutches....i was seriously bummed......pred helped it..when i first went into doctor with the beginning of lump, my gp said it was fine..a week later i was in hospital, ankle and foot swollen like a balloon.....they finally put me on iv steroids for 3 days...
Its all part of the inflamatory family, not everyone gets it, but if you do it can come in different levels I believe.....not fun.......

I have noticed that the erythema is almost a warning flag for my flares but I know it's not for everyone. If it gets to the point where walking is painful my GP gives me Naproxen for the pain and sometimes anti-biotics to get rid of them. I'm not supposed to go on steroids anymore because i become severely dependent on them so the anti-biotics are a good alternative.
Also I was just wondering is it only supposed to be on the legs because I got one little patch just above my elbow and I'm sure it's erythema. And is it only Crohn's patients that get it or Colitis also?

I usually get it on my foot (top) just below the ankle in a circle, but I currently have them on the top of two of my fingers just below the nail bed. They hurt worse on my fingers than my foot though I don't know why. Sometimes I just get them and sometimes it's before a flare.

Can anyone explain the difference between erethema no. and pyoderma gangrenosum? Is it just a matter of degree, the PG being more serious? What Natalie38 describes as EN sounds a lot like what I have that has been diagnosed as PG. It started out like a bad spider bite on my lower leg and spread, got very sore, swollen, hot, with multiple bleeding sores. I have had this now on both legs, currently on 30mg pred and 150mg Azithioprine which is clearing it up but when I reduce the pred it starts to come back.
I don't associate this with a flare but just with my screwy immune system. I've had my colon removed due to long term UC.

I have no idea. I know with erethema I get red bumps that are tender to the touch, sometimes they circle, and sometimes they appear all by themselves. They did a biopsy which came back erethema.

I'll have to look up pyoderma. I had these bizarre things on my thighs (both sides) and they called in four different docs to look at it. One said she had no idea, one said he thought shingles, another two separate bug bites, and the last said to just put me on high doses of antibiotics since I'd had sepsis a few months ago. Whatever they were, in about ten days they were both gone. About the size of a quarter, itchy, multiple tiny sores as they healed. Never had them before and hope to never have them again. They were painful.

I just looked at the pictures and they sure look like what I had on my legs. I'm no doctor, but the next time I get one, I'll show him the web link to what you described.

I have had erythema nodosum twice and both times it was not pretty. The most recent time was about a month ago and I had the painful red bumps on both shins and calves. I was really hoping to not have to resort to prednisone again so I tried to wait it out. We went on a family trip to Mexico on the 19th and by the end of the plane ride there, my right ankle was very painful and very swollen. A few days into the trip, I broke down and bought over-the-counter prednisone (in Mexico, who knew? Although I didn't feel all that comfortable getting it). Within a few days, my ankle and legs were feeling MUCH better. Now I'm in that stage where the skin is all nasty and peeling and looks really bruised, but it's not painful anymore. Unfortunately now I have to do the whole tapering off the prednisone ordeal, but I didn't have much of a choice!

I had this also a few months ago. I had started taking LDN at the time, the dose must have been too high for me. I think it ramped up my immune system because I had many other odd symptoms. Fatigue, my D increased and I was wheezing with cough.Aching joints too. I had a biopsy done from my dermatoligist and he confirmed it was E.N. My doctor reduced the dose of LDN and everything calmed down without me taking pred. I got another small red lump on my ankle a month after the big ones healed. It was Definately caused by my immune system going crazy. Bree

I have EN right now on both ankles/shins. It has been about 6 weeks since it started. I am now in bed rest for a week, Celebrex and they are going to give me potassium iodide drops. Because of my long history of steroid dependence the pred is out.

About 17 years ago I had Pyoderma, those were ulcers on the skin. The EN the skin has not broke. Just swollen, red, hot to touch. My ankles just feel like really bad arthritis pain, even laying down they are fairly painful.

Also in a flare right now, but am off drugs while awaiting enterence into the Stelara trial in a month.

I've had eurethema twice. It seems like when I got it I was also having a flare up of my Crohns and joint paint and shortness of breath, like an immune system meltdown. I started on LDN a year and a half ago and haven't got it since. I also haven't had any Crohns symptoms except for one fistula that won't heal. I've had three small ones close up. The only drug I'm on is LDN now. I had severe Crohns before I took it. You might want to read up on it. It might help with that EN too. Bree

Did your Dr. prescribe the Low Dose Naltrexone? I haven't found any data that says it has been proven to work for autoimmune problems, like EN, PG or Crohns. There seem to be a lot of claims about it, but it's hard to separate fact from hearsay.

My doctor prescribed it. It's a drug that's been used for 20 years. It is an opioid blocker used to treat drug addicts. They use it in a huge mg. dose, but in a tiny dose works miracles with many auto-immune diseases. It's cheap, so don't except big tv commercials about it. I've had no side effects whatsoever, and there's many medications I can't take. There are groups about it on yahoo to find out much more info. It took it 4 months to take full effect for me. My doctor had to lower the dose a little bit. There's a pharmacy here that compounds it for me at $31 a month. That's pretty good I'd say! Bree

Richard414 said:

Did your Dr. prescribe the Low Dose Naltrexone? I haven't found any data that says it has been proven to work for autoimmune problems, like EN, PG or Crohns. There seem to be a lot of claims about it, but it's hard to separate fact from hearsay.

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Here are two studies with good results for people with Crohn's who took LDN:

Low Dose Naltrexone Crohn's Study One
Low Dose Naltrexone Crohn's Study Two

Thanks to both of you. My main interest at this point is treatment of PG. I've had a total colectomy and j-pouch (due to UC) and developed the PG a little over a year ago. I'm on pred. and asathioprine which help but it doesn't totally clear up. If you know of any related studies, let me know.
Thanks again

I had PG 11 years ago on my right shin, was awful and stayed for four months and left me with scarring all up my shin, which thankfully has faded quite a bit. That was 1 year before I was diagnosed with Crohns. I now have EN on my shins, had a panic when it first appeared thinking it was PG again, my Crohns has been grumbling a bit but not flaring. I am also 12 weeks pregnant so the only treatment I can get for it is Hydrocortisone cream.

Hi, The woman I work for also got EN when she was pregnant (quite a few years ago). She has no other autoimmune problems that she knows of, and it did not come back after the pregnancy.
How does your EN differ from your PG? My PG has not returned but it has only been a year since it flared up, but I'm having other autoimmune problems. Of course I have scarring from it.

My PG started as a lump, the doctors thought it was an allergic action to an insect bite a t first then a couple of weeks later it just kind of burst ans ulcerated, which then started spreading down my shin, they didn't know what it was for ages and kept giving me different creams and antibiotics, which did nothing. EN has been really hard red, very painful lumps on both shins, the ones on the right have started to flatten now

I had a similar experience with my PG. I thought it was a spider bite and the first Dr. I saw agreed and treated with antibiotics which did nothing. Fortunately, I soon saw another young Dr. who did some research and came up with the PG diagnosis. He made the connection because of my long history of UC. I was then started on Prednisone and then after seeing a dermatologist, I was also put on Protopic ointment and a steroid cream. I had it on both shins, but so far it has not returned.