Clinical cases
DIAGNOSIS AND TREATMENT DIFFICULTIES IN A MULTIPLE RELAPSING CASE OF ERYTHEMA NODOSUM

Summary

Erythema nodosum (EN) is an inflammatory reaction that involves the skin and subcutaneous fat, presenting as tender, erythematous nodules on both shins. It is associated with infection, drug intake, inflammatory conditions, malignancy, or pregnancy. In most cases, it is an acute process with self-limited clinical evolution. Therapeutic options include extended bed rest, NSAIDs, colchicine, or oral potassium iodide for pain management. Systemic corticosteroids may be prescribed in cases with severe symptoms, but only if infection, sepsis, and malignancy have been ruled out. We present the case of a 26-years old female diagnosed with relapsing erythema nodosum. In this case, the Covid-19 infection might be the first trigger of EN, subsequently maintained by other infectious agents. Diagnosis and treatment difficulties were due to Covid-19 epidemiological context and lack of gastrointestinal and pharyngeal symptoms. This paper is the first publication from Romania, presenting an association between Covid-19 infection and a relapsing EN case in a young patient without other diseases.