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.
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