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Suggest treatment for erythema nodosum

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Posted on Tue, 28 Jun 2016
Question: My wife is taking (KI) potassium iodide for the treatment off eyrthem nodosum but not yet certin that is problem need to know what noduls tender and red with 1/4inch lession on lower inside of left leg could possibly be and what else I could do to help? I founf ki online and we are four days into it with taking one dose 130mg pill she has had this problem now for almost a year went to ruhmetologist, ppo, and vein specialist, lead to erythema came from wound dr who helped treat lession with debreeding and doing biopsy on leg now what can I do to help my wife
doctor
Answered by Dr. Shruti Rijhwani (42 minutes later)
Brief Answer:
I think you should see a rheumatologist .

Detailed Answer:
Dear Sir,

Thank you for posting your query on HCM.

Well looking your query I will like to tell you that , erythema nodosum is a clinical diagnosis . since dermatologist has seen you I will believe she has erythema nodosum. It should respond to respond to NSAIDs like Naproxen 500 mg . First , whether she has been taking oral contraceptives ? , second sarcoidosis needs to be ruled out . Can you send me the investigations that have been done so that am able to understand the disease better and guide you further .

Take care.

Dr. Shruti
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shruti Rijhwani (31 minutes later)
08/31/15- 10/29/15 podiatry dr, 11/03/15 diag code E039 family dr, 11/16/15 ana screen,ifa, angiotensin 1enzyme,sed rate, automated, rheum factor(qn), c-reactive protein, cbc,plt,diff, viper venom, diluted, thrombo time, partial, cardiolipin ab(igg), urin auto w/o scope, hep c ab, hepatitis b surface, cyclic citrull pepccp ab, 25-oh vitamin D-3, urea nitrogen (qn), creatinine(bl), hepatic function panel, ana pattern, cryoglobulin, an a screen, 14.3.3eta protein, 11/29/15 US Duplex scan of extremity vein radiologist, skin left lower leg shave biopsy: subacute spongiotic dermatitis with eosinophils, stassis dermatitis, dermatologist 1/5/16 bx skin subcutaneous&/mucous membrane 1lesion, wound dr special stains grp 1microorg, infectious disease dr allergy skin test 2/23/16 rt chest, two views, frontal and lower extremity wo/ w contras rt tibia and fibula two views, radiology diag chest xray, wound dr topical 2% xylocaine prior to debridement, apply gentamicin .1%, cover with adaptic, dry gauze, kerlix secure with tape.
doctor
Answered by Dr. Shruti Rijhwani (2 hours later)
Brief Answer:
Follows.

Detailed Answer:
Dear Sir,

Thank you for posting your query on HCM.

Please upload the reports as provided by the lab along with result values and their normal ranges as different labs have different normal values . Plus in biopsy it's stasis dermatitis they have given as report so that's a different identity altogether . But by the amount of tests they have done your wife has been investigated thoroughly so they must have treated her accurately .

Dr. Shruti
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Shruti Rijhwani (30 minutes later)
Thank you however that was initial dr report then noduals opened up which makes me wonder since the other dr wound dr was the first to id it as EN but it started to have lessions could it possibly not be EN due to length of time and lessions. Mayber it could be erytheme induratum, i m not sure just trying to help her with the pain but the potassium iodide has stoped the swelling but there is a new lession breaking through dermis.
doctor
Answered by Dr. Shruti Rijhwani (13 hours later)
Brief Answer:
Follows .

Detailed Answer:
Dear Sir,

It would be very difficult to say anything , without seeing the lesion and biopsy . Even cutaneous PAN presents like that . one thing you can do is to get the biopsy slide reviewed by other pathologist because whole treatment that will be suggested will depend on biopsy report .

Dr. Shruti
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Shruti Rijhwani

Rheumatologist

Practicing since :2008

Answered : 2366 Questions

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Suggest treatment for erythema nodosum

Brief Answer: I think you should see a rheumatologist . Detailed Answer: Dear Sir, Thank you for posting your query on HCM. Well looking your query I will like to tell you that , erythema nodosum is a clinical diagnosis . since dermatologist has seen you I will believe she has erythema nodosum. It should respond to respond to NSAIDs like Naproxen 500 mg . First , whether she has been taking oral contraceptives ? , second sarcoidosis needs to be ruled out . Can you send me the investigations that have been done so that am able to understand the disease better and guide you further . Take care. Dr. Shruti