We describe two cases of erythema induratum of Bazin (EIB), a cutaneous form of TB. •. Cases had no signs of active TB, but had a positive Interferon Gamma. Erythema induratum is a panniculitis on the calves. It occurs mainly in women, but it is very rare defined pathogen. The medical eponym Bazin disease was historically synonymous, but it applies only to the tuberculous form and is dated. Erythema induratum (also referred to as erythema induratum of Bazin (EIB) or nodular vasculitis) is a chronic nodular skin disease that is thought to represent a .
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This page was last edited on 9 Julyat If negative, this should be followed up in weeks with the standard 5TU per 0. As such, once a diagnosis of a tuberculid is made, a thorough investigation to evaluate for subclinical or active TB infection should be pursued.
Erythema induratum is a panniculitis on the calves. Systemic Implications and Complications Although usually latent, cases of active TB infection associated with erythema induratum have been reported lungs, pleura, pericardium, peritoneum, lymph nodes, and endometrium. Although the majority of cases present with a lymphocytic vasculitis, it is not a diagnostic requirement; ie, the absence of vasculitis does not exclude the diagnosis of EIB in an otherwise appropriate clinical context.
Subcutaneous nodule with overlying poorly defined violaceous erythema on the posterior leg The plaques are generally erythematous and indurated, with an overlying scaly surface, and may or may not be tender to deep palpation. Similar regimens have been shown effective in erythema induratum even in the absence of proven TB.
Infobox medical condition new Articles to be expanded from July All articles to be expanded Articles indurxtum empty sections from July All induratun with empty sections Articles using small message boxes All stub articles. Explain to the patient the importance of compliance with anti-tuberculosis treatment before beginning therapy. Patients with cutaneous polyarteritis nodosa may additionally present with generalized symptoms including fever, malaise, joint and muscle aches as well as neurological symptoms including numbness, tingling, sensory disturbances, weakness, and areflexia, whereas patients with EIB are classically asymptomatic.
As such, the development and presentation of lesions fluctuate based on the underlying immune status of the host. Treatment options for erythema induratum Medical Treatment Surgical Procedures Physical Modalities Anti-tuberculosis treatment rifampin, isoniazid, and pyrazinamide Not indicated Rest Non-steroidal anti-inflammatory agents Compression stockings Potassium iodide Supportive bandages Dapsone Oral gold salts Doxycycline.
Subsequent authors questioned the causal relationship between EIB and TB, citing the lack of tuberculoid granulomas or acid-fast bacilli in lesional biopsies of EIB; patients and the inability to induce tuberculosis lesions in guinea pigs by inoculation. Papulonecrotic tuberculid differentiated clinically by the tendency toward lesion necrosis and subsequent crusting eritdma histologically by location indurztum the superficial dermis compared to the more characteristic location of EIB in the subcutaneous fat.
Less commonly, lesions may appear on the thighs, buttocks, arms and rarely the face and ears. Acquired generalized lipodystrophy partial: Create a personal account egitema register for email alerts with links to free full-text articles. Fresh crops of nodules appear in periphery of ulcer and ultimately break down.
No pathognomonic histologic feature of erythema induratum exists, and histologic findings may vary with the age of the lesion Figure 2. Characteristic findings on physical examination On physical examination, affected patients will frequently have heavy or column-like calves, erythrocyanosis, cutus marmmorata and some degree of venous insufficiency.
Mycobacterium-related cutaneous conditions Infection-related cutaneous condition stubs. The plaques are generally erythematous and indurated, with an overlying scaly surface, and may or may not be tender to deep palpation.
In nodular stage, pain is present; induratkm it subsides in ulcerative stage. Hong Kong Med J. Erythema induratum classically presents during early adolescence and peri-menopause as subcutaneous poorly defined erythematous plaques and tender violaceous nodules.
What you should be alert for in the history Erythema induratum also referred to as erythema induratum of Bazin EIB or nodular vasculitis is a chronic nodular skin disease that is thought to represent a hypersensitivity response to Mycobacterium tuberculosis or its antigens.
Disorders of subcutaneous fat M The disease preferentially affects the posterior and anterolateral aspects of the lower legs of women; however it can occur in other locations as well as in men and children. Caseation necrosis is a late finding evident in approximately one half of cases.
Purchase access Subscribe now. Congenital generalized lipodystrophy Familial partial lipodystrophy Marfanoid—progeroid—lipodystrophy syndrome Poland syndrome. Create indurratum free personal account to access your subscriptions, sign up for alerts, and more.
Erythema Induratum (Erythema induratum of Bazin, Nodular Vasculitis)
Treatment Options Treatment options for erythema induratum are summarized in Table I. Abnormal arterial supply causes low-grade ischemia of ankle region. The tuberculous origin of erythema induratum Ela chronic nodular eruption of the lower legs, has long remained circumstantial, since Mycobacteria cannot be cultured from lesional specimens.
The prognosis of erythema induratum is excellent with appropriate treatment. Nonsteroidal antiinflammatory agents Bzain may alleviate discomfort associated with nodular or ulcerated lesions and should also be considered.
In hot weather, ankle becomes hot, edematous, swollen and painful. Create a free personal account to download free article PDFs, sign up for alerts, customize your interests, and more. Serological studies including antistreptolysin bxzin O, hepatitis A, and B, Mycoplasma, Bartonella, and Epstein-Barr virus may additionally be positive.