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The Journal of the American Board of Family Practice 18:567-569 (2005)
© 2005 American Board of Family Practice

Brief Report

Successful Treatment of Chronic Erythema Nodosum with Vitamin B12

Ilia Volkov, MD, Inna Rudoy, MD and Yan Press, MD

From the Department of Family Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel

Correspondence: Corresponding author: Ilia Volkov, MD, Department of Family Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, PO Box 84105, Beer-Sheva 84514, Israel (e-mail: r0019{at}zahav.net.il)

A 38-year-old woman presented with painful lesions on both shins that first appeared a few days earlier. Physical examination revealed multiple red tender nodules on both legs. The patient had been treated with nonsteroidal anti-inflammatory drugs for having a few months without any improvement. The patient was referred to a dermatologist and a rheumatologist, who confirmed our diagnosis of chronic erythema nodosum (EN). She returned to the clinic 3 months later complaining of having numbness in the soles of her feet for a few weeks. Her serum vitamin B12 level was 118 pg/mL (normal range 135 to 911). After 4 weeks of twice weekly injections of vitamin B12 at a dose of 1000 mcg, there was a clear alleviation of the numbness, and the EN completely resolved without evidence of recurrence on follow-up. Because it seems that vitamin B12 caused resolution of EN in this case, we recommend that physicians consider testing for vitamin B12 deficiency in patients with EN.






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Copyright © 2005 by the American Board of Family Medicine.