00:01 Our topic now brings us to erythema nodosum. 00:06 Right off the bat, I’m just going to tell you what’s happening with nodosum. 00:08 We’ve seen this a few times already. 00:10 Now, we’re just going to summarize what’s actually happening in dermatology. 00:14 Most commonly, it would be located on the anterior aspect of the legs down by the shin. 00:18 Can you go down there for me, please, and picture that? And upon palpation, this hurts, it hurts. 00:25 This is also known as panniculitis. 00:27 Welcome to erythema nodosum. 00:30 Involves the septa between the fat lobules. 00:34 I’m going to stop here for one second. 00:36 So, if you were to take a look at the anterior aspect of the shin or the shin in general, and you notice there is erythema and it’s painful and maybe a little bit of yellow discoloration, which is not uncommon, this is because it’s involving the septa between the fat lobule. 00:53 Usually idiopathic. 00:54 However, there is a long list of causes, long list. 00:57 I can’t just say that it’s caused by sarcoidosis. 01:01 I cannot just say that it’s caused by coccidioides. 01:04 I can tell you that it’s caused by whole -- or should I say it’s a sequelae or manifestation that you’re going to find with the whole host of systemic fungal infections or infections in general. 01:15 May be non-infectious such as sarcoidosis. 01:19 So may be secondary to inflammation including infections, coccidioides, Histoplasma, blastomycosis, autoimmune diseases, maybe medications, and maybe hormonal, perhaps, oral contraceptive pills. 01:33 What are you paying attention to with erythema nodosum? You’re down by the shin, and apart from the erythema, there might a lipid or yellow type of appearance, and it’s painful. 01:45 Another name for this is panniculitis. 01:49 Morphology: Tender, subcutaneous nodule on the anterior shin, most commonly. 01:55 Could you find this on other locations? Sure, you can, but go with what’s most common, I beg of you. 02:01 Morphology. 02:02 Take a look at the shin of your patient. 02:05 Raised, erythematous, painful nodule on the anterior shin. 02:11 As soon as you hear this, you know that you’re looking for an underlying cause, right? That’s your clinical approach. 02:17 So, it’s not like you’re seeing this and you’re treating the erythema nodosum. 02:20 That would only be symptomatic. 02:22 I mean, what you’re really going after is, wow, what’s the underlying disorder of my patient that is then resulting in such a manifestation? Pathology: Inflammation involving the subcutaneous fat.
The lecture Erythema Nodosum by Carlo Raj, MD is from the course Inflammatory Skin Diseases.
What is the pathology involved in erythema nodosum?
A 35-year-old man is seen in the office with tender, raised erythematous nodules on his anterior shin. What is your next step in the management of this patient?
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