Erythema nodosum of dental origin

The association of erythema nodosum and dental infectious foci has rarely been described in the literature. This report concerns four women who developed erythema nodosum either following dental treatment associated with gingival bleeding or due to infectious dental foci. In these cases, tooth extraction, removal of dental deposits, interrupted pulp treatment, apical periodontitis, or a relicted root were identified as causes of the development of erythema nodosum. Upon admission to the hospital, these patients also presented fever and and a maximally elevated erythrocyte sedimentation rate (ESR). In all instances, surgical treatment of the dental foci and/or administration of antibiotics rapidly led to the regression of the erythema nodosum, as well as to the normalization of body temperature and ESR. The cases described indicate that antecedent dental treatment and the possible presence of infectious dental foci should be considered in the differential diagnosis of erythema nodosum when taking the patient's medical history. This approach may avoid unnecessary, possibly invasive diagnostic procedures and can lead to rapid improvement in the patient's clinical status.