Treatment of secondary erythema nodosum in Behçet disease when oral prednisone has not achieved nodule resolution

Erythema nodosum arising as a manifestation of Behçet disease requires a specific management pathway. When a first-line corticosteroid course does not resolve the tender erythematous nodules on the lower extremities, the clinical situation calls for a structured escalation.

Clinical Scenario

Secondary erythema nodosum in a patient with Behçet disease. The treatment goal is resolution of tender erythematous nodules on the lower extremities.

Previous Line — Goal Not Achieved

Treatment with oral prednisone was the first step. The target — resolution of tender erythematous nodules on the lower extremities — was not reached. This protocol defines the next management step after that failure.

Next-Line Approach — Partial Overview

At this stage, biologic agents from the TNF-α inhibitor class have been used in recalcitrant cases. The specific agent, dosing schedule, and tapering approach are contained in the full structured protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1007/s40257-021-00592-w

Colchicine at 1–2 mg/day, adjusted to body weight, has been used mainly in patients with EN and Behçet disease.

Potassium iodide, colchicine, and dapsone are drugs used for treating neutrophilic dermatosis, making them a good option for EN associated with Behçet disease.

Tumor necrosis factor-α inhibitors such as etanercept, adalimumab, and infliximab have been used in patients with recalcitrant disease.

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