Treatment: disease is self-limited
Erythema nodosum is usually a self-limited disease. It may help to remove the offending medicine or allergen, if identified. Nonsteroidal anti-inflammatory drugs (NSAIDs) usually relieve symptoms.
In more severe or recurrent cases, potassium iodide 360–900 mg/d may be helpful, but the best effect is seen when it is used early in the course of the condition (level of evidence: 4).3
Systemic corticosteroids may help in the short term, but erythema nodosum may recur after discontinuing the medication. In addition, if there is an infectious cause, the use of corticosteroids may exacerbate the infection.
Conclusion: pain and swelling resolved
The patient began taking ibuprofen prior to the office visit and had achieved good pain control. This treatment was continued and the patient’s nodules resolved after approximately 4 weeks. Her leg swelling resolved 2 to 3 weeks after the clearance of her nodules. She resumed both the sertraline and mefloquine without problems.
Correspondence
Donald W. Shenenberger, MD, 1609 Emberhill Court, Chesapeake, VA 23321-1807. E-mail: docr15@cox.net.