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Lupus

Lupus or Erythema nodosum?

11/07/1998

Question:

A few months ago I notice bruise like swelling on my ankles every time I worked late nites at the Bar I was working at this summer. They appeared around the time my shift ended at 4:00 in the morning and lasted until that evening or the next day usually. I went to a doctor and she said it was probably Erythema nodosum. (not sure of spelling)this was the first time they appeared. She took blood tests and a few weeks later told me to go see my family doctor because my ANA test came back positive . I went to see him and he questioned whether it might be lupus as it was triggered by stress and exhaustion. He took more blood and a few weeks later his secretary phone and said everything came back fine. Now I have a small swollen spot on my elbow and I was showing it to a friend who is a pharmacist an d he remembered me being tested for lupus and asked if it was a Lupus lesion. He didn't realize that the doctor had said everything was normal. Should I bring this to my doctors attention? It is a small spot the size of a Quarter and it has been there for a month.

Answer:

In your question you mentioned a small swollen spot on the elbow. It is not clear whether this is a skin lesion or perhaps related to some joint problem. Lupus can have a variety of manifestations affecting both skin and joints. From your description, it would be difficult to say whether this, in fact, was a lupus lesion. Given its location, I think that it is unlikely to be a recurrence of the erythema nodosum. Since it has been there for a month, I would suggest showing it to your physician.

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Response by:

Anne-Barbara Mongey, MD
Formerly, Director, Arthritis Clinic, Univerity Hospital
College of Medicine
University of Cincinnati