Erythema Nodosum in Sarcoidosis — RACP Adult Medicine MCQ

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EasyRespiratoryErythema Nodosum in SarcoidosisRACP Adult Medicine

A 30-year-old woman presents with bilateral tender erythematous nodules on the anterior shins (erythema nodosum). She has bilateral hilar lymphadenopathy on CXR. ACE is elevated. She is afebrile. What is the most likely underlying disease?

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Correct answer: C — Sarcoidosis

Erythema nodosum with bilateral hilar lymphadenopathy and elevated ACE is Löfgren syndrome (acute sarcoidosis). EN is the most common cutaneous manifestation of sarcoidosis. Other causes of EN include streptococcal infection, IBD, TB, OCP, and idiopathic. The combination of EN + BHL + polyarthralgia = Löfgren syndrome with >90% spontaneous resolution.

Reference: BTS – 2020 – Sarcoidosis; eTG Respiratory 2024