aetiology
Last reviewed 03/2021
A wide range of antigenic stimuli are implicated:
Common causes include:
- idiopathic - up to 55%
- sarcoidosis - 30 to 40% of cases
- infectious causes:
- streptococcal/viral throat infections - most common
- chlamydia - relatively common
- tuberculosis - relatively common
- mycoplasma
- yersinosis - more common in non-UK European countries
- rarely, histoplasmosis, leprosy, psittacosis, cat-scratch disease, lymphogranuloma venereum
- inflammatory causes:
- inflammatory bowel disease:
- Crohn's
- ulcerative colitis
- rarely, Behcet's disease
- drugs are a common cause:
- sulphonamides
- oral contraceptive pill
- malignancy:
- lymphoma, leukaemia
- postradiation therapy
- pregnancy
Rare cause include:
- Infections
- Viral – herpes simplex virus, Epstein-Barr virus, hepatitis B and C viruses, HIV
- Bacterial - Campylobacter spp., rickettsiae, Salmonella spp., psittacosis
- Parasitic - amoebiasis, giardiasis
- malignancy:
- lymphoma, leukaemia
- postradiation therapy
- often no cause is found (1)
Reference:
- (1) Schwarts RA, Nervi SJ. Erythema Nodosum: A Sign of Systemic Disease. AFP 2007;75(5)
- (2) Sheretz EF et al.Skin reactions to systemic disease. Medicine International (1992);102:4278-81
- (3) The Practitioner (2001);345:937-41.