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It consists of a reaction in the skin and deeper tissues that almost always occurs on the shins. Usually, several tender red nodules are present on both legs. The real significance of erythema nodosum lies in the possibility of a serious underlying disease. Although in some cases no such underlying cause is found, most are associated with either a drug that has been taken, an inflammatory condition elsewhere in the body, or an infection. The disease's association with oral contraceptives and sulfa, a drug component that is commonly used to treat urinary tract infections, may be why it is seen more frequently in women. Chlamydia, tuberculosis, and other bacterial and fungal infections may also be associated with erythema nodosum, but fungal infections involving only the skin, such as athlete's foot, are not.
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