Although infectious causes have been suggested, no specific etiologic agent has been found. It responds quite well to treatment, but recurrences are possible. There appears to be no racial predilection. Most commonly, patients describe a painless red nodule that enlarges via centrifugal expansion or by confluence of other nodules in proximity. There is usually no report of trauma to the affected area.
Some patients describe concurrent sore throat, fever or arthralgias.
The lesion displays peripheral extension, and the central portion may present a yellowish hue later in the course. There is a characteristic lack of ulceration of these lesions. There appears to be no obvious cause, but some reports document streptococcal infection in some patients. Erythrocyte sedimentation rate is commonly elevated in patients with Vilanova disease. Anti-streptolysin O titer should be checked, as it is elevated in some patients.