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The lesions generally tend to regress within three or four weeks spontaneously. New crops of lesions may continue to appear up to 6 weeks. Even though the diagnosis is based on mainly typical clinical characteristics, deep incisional biopsy may be beneficial for atypical cases. Histopathological examination reveals hypodermal septal inflammation without sign of vasculitis. The exact pathogenesis remains unclear even though it is considered to be a hypersensitivity reaction against various antigenic stimuli. It may occur in association with a wide variety of causative stimuli including infection diseases, drugs, inflammatory bowel disease (IBH), sarcoidosis, tuberculosis, Behcet’s disease (BD) and malignancy. Despite most cases have no clearly identified causative factor, it may be a cutaneous sign of systemic serious comorbidity [1,3,4].

Data analysis of 287 patients present with erythema nodosum: A closer look at associations