This protocol addresses secondary erythema nodosum in a patient with inflammatory bowel disease whose initial conservative management did not achieve resolution of tender erythematous nodules on the lower extremities.
The concurrent presence of inflammatory bowel disease shapes the treatment approach. Caution is warranted with non-steroidal anti-inflammatory drugs in this population, as they may worsen IBD symptoms — narrowing the range of options available for managing the erythema nodosum.
An initial course of compression bandages and limb elevation for oedema and pain relief was undertaken but did not achieve the target: resolution of tender erythematous nodules on the lower extremities. This protocol defines the structured next step after that failure.
Systemic pharmacological therapy has been employed in EN associated with IBD when conservative measures prove insufficient. The specific agents and the full structured regimen are available in the complete protocol.
Resolution of tender erythematous nodules on the lower extremities.
Caution should be taken with the use of non-steroidal anti-inflammatory drugs in patients with IBD as these drugs may worsen IBD symptoms.
Thalidomide and cyclosporine A have been used in EN associated with IBD.
DOI: 10.1007/s40257-021-00592-w
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