Introduction: Dermatologic pathology can be both challenging and frustrating in the Family Practice setting. Case presentation: We report the case of a 38-year-old female that presented initially with a few, small red nodules on both the upper and lower extremities, which were painful to touch. This patient had an extremely vague picture, which included recent upper respiratory infection and recent travel to Europe. Erythema Nodosum was suspected and work-up initiated to determine underlying cause. ASO titer ultimately confirmed recent Streptococcal infection. Although the primary diagnosis was not made until follow-up visit, treatment was started based on understanding of common causes of Erythema Nodosum. Conclusion: Using the patient's history, a differential diagnosis knowing the common causes of EN can help direct diagnostic evaluation.