Erythema nodosum

QUESTION 29

A 40-year-old woman presents to the dermatology clinic with a painful rash on the lower legs. The rash appeared suddenly on her bilateral legs with firm, painful nodules underneath the skin and seemed to spread within 1 week. Her medical history is notable for hypertension, poorly controlled Crohn’s disease and fibromyalgia. On physical examination, there are numerous red-brown subcutaneous nodules that are painful to the touch on the patient’s anterior lower legs (29). A biopsy is performed and demonstrates a septal panniculitis with lymphocytes and scattered neutrophils.