Could My Erythema Nodosum Have Progressed to Cellulitis?
I’ve posted about my situation a few times, but my previous messages may have been too lengthy, causing readers to lose interest. To keep it concise: I’m a 27-year-old woman, weighing 170 pounds, and I am four and a half months post-delivery. I visited my doctor, where I was diagnosed with Erythema Nodosum based solely on visual examination, with no biopsy conducted. A chest x-ray ruled out sarcoidosis, and I subsequently had a lab test that revealed some abnormalities: - MCH: Low at 26.8 pg - EDW: Low at 35.1 fL - C-reactive protein: Elevated at 49.5 mg/L Although I was diagnosed with Mononucleosis, I haven’t experienced any symptoms related to it. Given that I’ve barely left my home since giving birth, I found it hard to believe but I accepted the diagnosis for the time being. Now, four weeks later, there are still no signs of mono, yet the nodules on my legs have increased significantly. Almost all of my lower legs from the knees down are hot, inflamed, and swollen. There’s noticeable fluid retention, resulting in deep indentations when pressure is applied, which can take 2-3 minutes to subside. Along with this, I am experiencing persistent sharp pain and tenderness in my shins and calves. My main worry is that these symptoms began as small, circular red nodules. Now, over a month later, about 75% of my leg's surface area is entirely reddened and inflamed, accompanied by newly formed severe hives. I can’t see a doctor until mid-July, and the hospitals are currently overwhelmed. Should I consider a trip to the emergency room, or could this be a normal development stemming from Erythema Nodosum? Is there a chance I might have cellulitis? I’m also aware that conditions like lupus, leukemia, lymphoma, and other cancers could lead to a false positive for mono. Therefore, should I pursue further testing, or is this expected with chronic cases of EN? As an additional note, I've recently observed that my legs experience pain and tingling when I exhale. I'm uncertain if this is related. Thank you for your insight!
Answers (1)
6/21/2025, 7:01:25 AM
OpenHealth AI
It sounds like you're going through a challenging time with your symptoms and concerns. The significant increase in inflammation and pain in your legs could suggest a few things, including the possibility of cellulitis, especially given the warmth, swelling, and redness you've described.
Key Points:
- Current Symptoms: Your increased inflammation, swelling, and fluid retention, along with sharp pain and new hives, are concerning and may require urgent evaluation.
- Potential for Cellulitis: The swelling and warmth in your legs could indicate cellulitis, which is a bacterial skin infection that requires prompt treatment.
- Next Steps: Safety is the priority, especially considering your symptoms and recent history.
Explanation:
Erythema Nodosum (EN) can cause painful nodules typically related to underlying conditions. While it's possible for EN to persist and evolve, your symptoms’ intensity (increased redness, swelling, and new hives) could also signify an infection, particularly if your skin is tender and red over a large area. The pain and tingling associated with exhaling may also warrant attention, though it might not directly relate to the EN or cellulitis.
Immediate Actions:
- Visit the Emergency Room: Given the extent of your symptoms—especially with the presence of severe redness, swelling, and pain—it is advisable to seek medical attention immediately. Cellulitis, if it is present, can escalate quickly.
- Document Symptoms: Keep a detailed log of your symptoms, including when they started, their progression, and any other systemic symptoms (like fever or chills) to share with medical personnel.
- Avoid Pressure on Affected Areas: Try to keep your legs elevated when possible to reduce swelling and avoid irritating the inflamed skin.
Your health and comfort are paramount, so seeking immediate medical evaluation is the best course of action. This ensures that you receive the necessary care and any further diagnostic tests needed to address your conditions. Please take care of yourself and prioritize getting help.
Related Questions
Seeking Clarity on Brain MRI Results
I’m a 36-year-old man experiencing occasional headaches, and I have no additional health concerns. I take Lexapro for anxiety and Ativan as needed. Earlier this week, I underwent a non-contrast MRI scan of my brain, and I have received the following report: **REASON FOR EXAMINATION:** Periodic headaches described as dull in nature. **COMPARISON:** None available. **TECHNIQUE USED:** The imaging included sagittal T1, axial FLAIR, axial T2-weighted, diffusion-weighted, and coronal gradient-echo sequences of the brain. **RESULTS:** The size of the ventricles and sulci appears to be normal. The position of the cerebellar tonsils is also within normal limits. Notably, a bilobed, septated lesion measuring 18 x 10 mm is located in the right parietal cortex, associated with some underlying edema or gliotic changes and cortical expansion. The pituitary gland size is normal. There are no signs of intracranial bleeding or any indications of recent infarcts in the cerebral regions, brainstem, or cerebellum. No abnormalities were detected on diffusion-weighted imaging. Additionally, there are no signal changes that would imply a demyelinating condition, such as multiple sclerosis. There are no fluid collections outside of the brain or subdural hematomas noted. Major blood vessels are patent, as indicated by the flow voids. The paranasal sinuses and mastoid air cells appear clear, although there is mild mucosal thickening in the left anterior ethmoidal air cells. **SUMMARY:** The findings suggest an 18 x 10 mm intra-axial cystic lesion in the right parietal lobe, accompanied by mild underlying edema or gliotic changes. This could possibly be an atypical manifestation of enlarged perivascular spaces or a benign cystic structure. Further evaluation with postcontrast imaging is advised. The overall conclusion of the MRI is otherwise normal. I’m feeling really anxious about these findings. Can anyone help me understand what this might mean?
Understanding Prednisone Usage and Withdrawal
A 38-year-old woman, measuring 5’10 and weighing 125 pounds, with no smoking or drinking habits and a background of autoimmune disease, encountered a viral infection in December. In response to her condition, a specialist recommended a tapering regimen starting with a 40mg dose of prednisone for five days, followed by a gradual reduction through 30mg, 20mg, and 10mg over a total period of 20 days. After completing the course and halting the medication, she experienced severe symptoms approximately 36 hours later, including intense vomiting, debilitating headaches, and widespread pain throughout her body. Any physical contact provoked discomfort, leaving her in distress. Unable to reach her original provider, she consulted another physician who prescribed a lower dosage of 4mg of prednisone, instructing her to decrease the amount by 1mg every three days. Remarkably, she felt relief upon returning to the 4mg dose. However, she expressed concern regarding the potential effects when she ultimately weans off the medication entirely. She is seeking guidance on whether this method of tapering is typical and which specialist might be best suited to manage her prednisone treatment moving forward.
Recurring Mysterious Rash Every Year, All Tests Negative
Hello everyone! I'm an 18-year-old female, and I don't consume alcohol, smoke, or engage in any recreational drug use. Around the middle of January last year, I noticed a gradual appearance of a rash across my body that escalated into a severe illness after approximately a week and a half of its onset. Currently, I find myself in a similar situation, suggesting that this might be a yearly recurring issue. At the moment, the rash isn't itchy, although I've recently had a mild sore throat. Thankfully, I don't have any other signs of illness right now. Last year, when I was unwell, it was an incredibly challenging experience; I felt extremely weak, had a runny nose, persistent cough, sore throat, and even experienced moments of confusion due to fever. The rash did become itchy once I fell ill. During last year's episode, I sought medical advice and underwent several tests while dealing with the rash. All results came back negative, including tests for mononucleosis. The only positive result was for a common cold. Having received vaccinations for measles, mumps, and rubella during my childhood (despite having had those diseases), I'm fairly certain this isn't related to any of them, and I believe I tested negative for those as well last year. Any insights or advice would be greatly appreciated! Thank you from a financially struggling college student!
Persistent Swelling in Armpits for Over a Decade Without Discomfort
Hello everyone! I’ve been dealing with persistent swelling in my armpits for over ten years now. The swelling is more pronounced on the right side compared to the left. Interestingly, there is no pain associated with it, and both areas are soft to the touch. I don’t have any other health conditions that could be linked to this issue. Does anyone have insights on what might be causing this?
Navigating MALS Challenges: Seeking Guidance
Hello everyone! I’m a 36-year-old female dealing with multiple health conditions, including EDS (Ehlers-Danlos Syndrome), MALS (Median Arcuate Ligament Syndrome), and ulcerative colitis, among several other unrelated issues. I wanted to share my experience with MALS, which has been confirmed for me. Back in May 2024, I underwent revision surgery. Unfortunately, the recovery did not go as hoped. Due to my EDS, the celiac artery lacks the ability to function independently, which my surgeon described as it being "too floppy." At that time, I accepted this outcome because the excruciating pain had subsided, and I was able to eat and gain weight again. However, now I find myself facing a resurgence of pain that is quite intense. A CT scan I had last week revealed severe stenosis in my celiac artery, coupled with a soft tissue prominence at the diaphragmatic crus and the beginning of the celiac axis. Currently, I’m taking Norco 10-325 three times a day and Lyrica 75 mg three times daily. While these medications provide some relief, the pain is overwhelming, and I can’t help but feel as if I’ve returned to my previous struggles from two years ago. Doctors are suggesting that the only option is to go in and "clean out the adhesions". I come to you all for your insights: Do you think pursuing a clean out procedure is advisable, or could it pose too much risk considering my EDS? I appreciate your thoughts and thanks for reading my story.