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woman with lumps on legs

Weird IBD Symptoms: Erythema Nodosum

Crohn’s disease and ulcerative colitis are digestive diseases, but most anyone who has lived with one of these diseases knows that it can also affect other parts of the body outside of the digestive tract. Personally, I have had a number of extra-intestinal manifestations of Crohn’s disease, but perhaps none as strange as the tender, red lumps that appeared on my legs.

Tender red lumps on my legs?

It happened while I was a college student and I developed these fairly large (I’d guess 1-2 inches in diameter) lumps along both of my shins. They were raised and the skin was shiny over them, likely due to the skin stretching. They were tender to the touch, but were not consistently painful. Along with these lumps, I also had a several inch long red mark along the back of one of my calves. This one was not raised, as the others were. The doctors biopsied the lumps and the mark on the back of my leg and determined it was a condition called Erythema Nodosum.

Erythema nodosum is caused by inflammation, so it is no surprise that it can be connected to inflammatory bowel disease.

In this case, the inflammation occurs in part of the fatty layer of skin. The lumps most often appear where mine were, on the front part of the shin, however, they can appear almost anywhere on the body. For me, they were mostly tender to the touch, but they can be more painful in some situations. Research has shown that up to 15% of patients with Crohn’s disease may develop erythema nodosum at some point.1 It is more common in women than in men and more often seen with Crohn’s disease patients, as opposed to those living with ulcerative colitis. It is most often seen at disease diagnosis or during a disease flare.2

If you develop this condition, a doctor will likely want to biopsy the lumps in order to confirm the diagnosis. The good news is that often the lumps will go away by themselves within a few weeks. In addition, some of the medications that are given for IBD are also used for Erythema nodosum, such as corticosteroids, so treating IBD will also treat this condition. Compression stockings, leg elevation, and rest can also help.1

One issue I found with the Erythema nodosum was that it was accompanied by increased joint inflammation, specifically in my ankles.

This is not something that has been connected through research, but merely my own personal experience. So while the lumps themselves did not cause too much of an issue for me, it was the ankle swelling that made it difficult to function.

This occurred when I was in a long-term Crohn’s disease flare and dealing with other digestive symptoms at the same time, clearly pointing towards an elevated amount of inflammation present in my body. This holds true to research studies that have shown Erythema nodosum is most commonly seen at IBD diagnosis or during a flare of symptoms.2 Thankfully, once the lumps are gone, they do not usually leave any permanent scarring. I do have a small scar from the biopsy, but it is not noticeable any longer.

So what’s it mean?

Erythema nodosum is simply another example of how Crohn’s disease and ulcerative colitis can contribute to conditions located outside of the digestive tract. If you notice these types of lumps at any point, be sure to speak with your gastroenterologist about it.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The InflammatoryBowelDisease.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Trikudanathan, G., Venkatesh, P. G. K., & Navaneethaii, U. (2012). Diagnosis and therapeutic management of extra-intestinal manifestations of Inflammatory Bowel Disease. Drugs, 72, 2333-2349.
  2. Karmiris, K., Avgerinos, A., Tavernaraki, A., Zeglinas, C., Karatzas, P., Koukouratos, T., … Koutroubakis, I. E. (2016). Prevalence and characteristics of extra-intestinal manifestations in a large cohort of Greek patients with Inflammatory Bowel Disease. Journal of Crohn's and Colitis, 10, 429-436.

Comments

  • thedancingcrohnie moderator
    9 months ago

    I have had Erythema Nodosum and it is not fun. My worst case with it was when I was first diagnosed with Crohn’s. The red lumps were everywhere from my hips down. One slight touch and I would yelp out in pain. They hurt so bad. Later, during a flare I got them again but this time just on my shins.

    Always dancing,
    Elizabeth (team member)

  • Sickforever
    2 years ago

    Thank goodness this is one thing I ‘ve never had happen to me ! I am sorry that you have to go through this ! I agree with you 100 % that every person with crohns is different. I have been trying to find out if anyone else has had problems with their vision from crohns ??? My eye Dr. Informed me that my loss of vision in both eyes is a direct complication from my crohns but I can’t seem to find anyone else that is having this same problem ?????

  • SusanHU
    2 years ago

    Hi sickforever! Thank you for the comment! I’d suggest leaving that as a Q&A if you don’t mind – you’re more likely to get some answers. =)
    https://inflammatoryboweldisease.net/q-and-a/

    Let me know if you need any help!
    – Susan (InflammatoryBowelDisease.net Team Member)

  • Stephanie Hughes moderator author
    2 years ago

    I have actually had some vision-related issues in the past due to Crohn’s in the form of uveitis or iritis. I actually have a post written that should be coming out soon with more detailed info, but essentially the inflammation can spread to your eye and can ultimately cause vision loss. Also, steroid use has been linked to cataract formation, so that’s a more indirect consequence of Crohn’s disease. I’m sorry you’re dealing with this. I hope your eye doctor can provide some solutions!

  • DebOz
    2 years ago

    I have had inflammation in the eyes from Crohns… Uveitis can damage vital eye tissue, leading to permanent vision loss. https://www.ibdrelief.com/learn/complications-of-ibd/eye-problems-in-ibd/eye-problems-uveitis-crohns-disease-and-ulcerative-colitis

  • 2 years ago

    On a few occasions, when my Crohn’s is in the flare, I have had severe pain in my chest every time I took a breath. It was pericarditis which is inflammation of the pericardium. The doctors said I was having a heart attack. I questioned that because it only hurt when I took a breath.

    I asked if it could be the inflation from my Crohns move to the pericardium. Both the GI doctor and the cardiologist told me that was not possible. However, after four days in cardiac intensive care they agreed that despite it been extremely rare that this is what happens with me.

    I think the inflammation can manifest itself in many why on many areas of the body

  • MzCatastrophe
    2 years ago

    I’ve had this happen two or three times in my 16 years of living with CD. The first time I swore I was dying. I was panicking because I didn’t have a will written out (I was only 21!!). I dealt with the pain for 8 hours, hoping it would pass so I wouldn’t have to go to the hospital, but finally, my breathing became so difficult I had no choice. I got in the car and my bf at the time drove me about 100 ft down the block when suddenly, it subsided as quickly as it came on. Inflammation is so strange and presents itself in some very scary ways.

  • Stephanie Hughes moderator author
    2 years ago

    I think that’s definitely the case, because nearly any health issue I’ve had that’s not directly related to the digestive tract is due to inflammation in some form.

  • 2 years ago

    I am so sorry you are dealing with this also. I have had these lovely lumps for several years. I had a few of the larger ones removed, but they continue to pop up in other places. I don’t have them during flares, they are just continually there.

  • Stephanie Hughes moderator author
    2 years ago

    I hate to hear that, but thank you for sharing. I did not even know it was possible to have them removed.

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