The physical examination revealed 6-8 mm erythematous nodules on her lower legs but was otherwise normal. Over the next 2 days the nodules became painful, interfering with weight bearing on the left leg, and the child's ankles and knees were warm with swelling below the joints. By day 22, the nodules had nearly resolved. It has been most commonly associated with yersiniosis, tuberculosis, leprosy, cat scratch disease, and streptococcal infections. EN is thought to be of immunologic origin and probably represents a hypersensitive reaction to a variety of antigenic stimuli, including drug therapy.
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