Erythema Nodosum: A Practical Approach and Diagnostic Algorithm

Daniela Michelle Pérez-Garza; Sonia Chavez-Alvarez; Jorge Ocampo-Candiani; Minerva Gomez-Flores


Am J Clin Dermatol. 2021;22(3):367-378. 

In This Article


The incidence of EN varies according to the triggering factor and its ethnic, racial, and geographic differences. In north-western Spain, the annual incidence rate of biopsy-proven EN for the population aged 14 years and older was 52 cases/million and the incidence was higher in the first half of the year when streptococcal infections are more frequent.[4] In Egypt, the foremost etiology reported between 1994 and 2002 was primary tuberculosis (TB),[5] while in Spain, sarcoidosis was the most frequent identified etiology.[4] Among adults, this condition affects women more frequently, with a male:female ratio of ~ 1:5.[6] In children, there is no difference regarding sex, up to the age of 12 years.[7] The maximum number of incidences occurs between the second and third decades although it can occur at any age.[8,9]