Many of your stories sound familiar. I was diagnosed with lupus in 2001 at age 17 after a severe flare up of erythema nodosum, along with pericarditis and various other symptoms. At the time my rheumatologist didn’t call it EN, but over the past year EN has been added to my diagnosis, and we are currently waiting on sarcoidosis blood work to confirm that as well.
Last summer I had my EN biopsied by a young doctor, and it was a painful experience. They didn’t go deep enough to get enough fat cells, and the biopsy was inconclusive. I’m having another flare again now. Last week, I went to a more experienced dermatologist who was able to confirm the EN without a biopsy, by just looking at my “spots” as I call them. The nodules are painful before they are visible, and they gradually appear on my lower legs first. They start out as small bright pink/red dots, then grow in size & firmness. They get larger, dark and bruise-like, then eventually (with treatment) they fade out like a bruise. It often takes several weeks for the spots to completely fade even after the pain & swelling goes away. I always fear they will scar, but so far I have not experienced scarring.
When I have flares, I take prednisone. I have not been able to tolerate the Plaquenil. I also use naproxen for the pain, and otc Prilosec to combat the gastro issues. My dermatologist recommended coated baby aspirin for the pain this time, and I am giving it a try. After using aspirin for 2 days, I think the naproxen does a better job with the pain. Rest & elevation help me through the work day. Cold compresses and Epsom salt baths can be soothing in the evenings.
My heart goes out to all of you experiencing EN. Thank you for sharing your stories. It is comforting to know I am not alone. I am fortunate to have a team of doctors working to help me understand my situation, but I know it can be frustrating to have friends, family, and even doctors tell you that nothing is wrong when you are in pain and know something is not right.