When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Eritema nodoso

Last reviewed: 23 Aug 2025
Last updated: 30 Jul 2021

Summary

Definition

History and exam

Key diagnostic factors

  • presença de fatores de risco
  • nódulos nas canelas
  • uveíte, olhos vermelhos, nódulos retinianos ou gotas de vela
  • nódulos em outras áreas cutâneas
  • lesões cutâneas anestésicas
Full details

Other diagnostic factors

  • dores nas articulações
  • febre
  • diarreia, constipação, dor abdominal, hematoquezia
  • baço aumentado
  • nódulos miliares na retina
Full details

Risk factors

  • infecção por estreptococos
  • sarcoidose
  • tuberculose
  • coccidioidomicose
  • histoplasmose
  • blastomicose
  • brucelose
  • Doença de Behçet
  • contraceptivos orais
  • sulfonamidas
  • iodetos e medicamentos antiepilépticos
  • psitacose
  • lepra
  • doença inflamatória intestinal
  • gestação
  • neoplasia maligna
Full details

Diagnostic investigations

1st investigations to order

  • Hemograma completo
  • título de antiestreptolisina O
  • radiografia torácica
  • teste tuberculínico, teste de liberação de gamainterferona
Full details

Investigations to consider

  • nível sérico de enzima conversora da angiotensina (ECA)
  • biópsia de lesão cutânea
  • teste cutâneo de coccidioidina
  • teste cutâneo de histoplasmina
  • teste cutâneo de lepromina
  • sorologia para blastomicose
  • sorologia para brucelose
  • sorologia para psitacose
  • raio-x das articulações sintomáticas
  • teste do fator reumatoide
  • título de aglutinação para Yersinia
  • coproculturas para Yersinia
  • colonoscopia
  • imunoglobulina D (IgD) sérica
  • biópsias por punção profunda incluindo gordura subcutânea, ou biópsias incisionais
Full details

Treatment algorithm

ACUTE

sintomas leves a moderadamente graves

sintomas refratários graves

Contributors

Authors

Daniela Kroshinsky, MD, MPH
Daniela Kroshinsky

Associate Professor of Dermatology

Harvard Medical School

Director of Pediatric Dermatology

Director of Inpatient Dermatology

Massachusetts General Hospital

Boston

MA

利益声明

DK declares that she has no competing interests.

鸣谢

Dr Daniela Kroshinsky would like to gratefully acknowledge Dr Om P. Sharma, a previous contributor to this topic. Dr Kroshinsky would also like to thank Priyanka Vedak for her contribution to this topic. We would like to gratefully acknowledge the contribution of the late Elisabeth Higgins (Consultant Dermatologist, King’s College Hospital) for her peer review of this topic.

利益声明

OPS declared that he had no competing interests. PV declared that she had no competing interests. EH declared that she had no competing interests.

同行评议者

Robert T. Brodell, MD

Professor of Internal Medicine

Clinical Professor of Dermatopathology

Northeastern Ohio Universities College of Medicine

Warren

Associate Clinical Professor of Dermatology

Case Western Reserve University School of Medicine

Cleveland

OH

利益声明

RTB declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Bondi EE, Margolis DJ, Lazarus ZS. Panniculitis. In: Freedberg I, Eisen A, Wolff K, et al, eds. Fitzpatrick's dermatology in general medicine. 5th ed. New York, NY: McGraw-Hill; 1999: 1284-6.

Requena L, Requena C. Erythema nodosum (review). Dermatol Online J. 2002 Jun;8(1):4. 摘要

Sterling JB, Heymann WR. Potassium iodide in dermatology: a 19th century drug for the 21st century-uses, pharmacology, adverse effects, and contraindications. J Am Acad Dermatol. 2000 Oct;43(4):691-7. 摘要

Friedman ES, LaNatra N, Stiller MJ. NSAIDs in dermatologic therapy: review and preview. J Cutan Med Surg. 2002 Sep-Oct;6(5):449-59. 摘要

Schultz E, Whiting D. Treatment of erythema nodosum and nodular vasculitis with potassium iodides. Br J Dermatol. 1976 Jan;94(1):75-8. 摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

内容使用需遵循免责声明