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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Actinomycetaceae Actinomyces israelii Actinomycosis Cutaneous actinomycosis Tropheryma whipplei Whipple’s disease Arcanobacterium haemolyticum Arcanobacterium haemolyticum infection Actinomyces gerencseriae. While clinically and histologically similar, unlike nodular vasculitis, patients with erythema induratum typically demonstrate an increased cell mediated response to the Tuberculin Sensitivity or PPD skin test, which may result in a bullous type IV hypersensitivity reaction.
In patients with suspected EIB, start with a complete history and physical examination followed by administration of a purified protein derivative PPD tuberculosis skin test and an incisional biopsy involving an adequate amount of subcutaneous erittema. Other Early morning sputum, urine and gastric aspirates onduratum be helpful to rule out an underlying active infection, but are generally negative.
Serological studies including antistreptolysin titer O, hepatitis A, and B, Mycoplasma, Bartonella, and Epstein-Barr fritema may bazih be positive. Powered By Decision Support in Medicine. Arthropod bites and papular uticaria differentiated by the classically pruritic and non-tender nature of the nodules. The disease preferentially affects the posterior and anterolateral aspects of the lower legs of women; however etitema can occur in other locations as well as in men and children.
EIB exhibits a predominantly lobular or septolobular pattern of panniculitis indistinguishable from the non-M tuberculosis MTB associated cases classified as nodular vasculitis.
From Wikipedia, the free encyclopedia. Tuberculoid leprosy Borderline tuberculoid leprosy Borderline leprosy Borderline lepromatous leprosy Lepromatous leprosy Histoid leprosy. Sign in to access your subscriptions Sign in to your personal account. Patients are otherwise healthy without systemic symptoms and often present with a rash as the only symptom of their disease.
Even if an association with tuberculosis is assumed, the decision to start antituberculosis chemotherapy cannot be based on the diagnostic criteria required for the diagnosis of tuberculosis, eg, culture and microscopic detection of acid-fast bacilli. There is a strong female predominance of the disease Expected results of diagnostic studies No pathognomonic histologic feature of erythema induratum exists, and histologic findings may vary with the age of the lesion Figure 2. Lesional morphology may range from deep seated areas of subcutaneous induration to well-defined plaques and nodules, characteristically on the posterior or lateral aspects of the lower legs Figure 1.
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Pancreatic panniculitis differentiated clinically by temporal relationship to pancreatic pathology and spontaneous oily brown discharge from lesions due to liquefactive necrosis. Additionally, all states require a communicable disease report to be filed with the local county public health department, generally within 24 hours of identification.
Erythema Induratum (Erythema induratum of Bazin, Nodular Vasculitis)
Patients may seemingly have no risk factors for prior TB exposure, and be otherwise completely healthy. On palpationsmall superficial and painful nodules are felt. Nonulcerated lesions heal with only postinflammatory hyperpigmentation, whereas ulcerated lesions may heal with atrophic, hyperpigmented scars. Ulcerated nodules exhibit overlying crust with a rolled erythematous, blue-tinged border. Abnormal arterial supply causes low-grade ischemia of ankle region. induratmu
Nodules are typically cm in size, erythematous to violaceous in color, and have a tendency to ulcerate centrally. 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. Erythema induratum classically presents during early adolescence and peri-menopause as subcutaneous poorly defined erythematous plaques and tender violaceous nodules.
Robbins and Cotran pathologic basis of disease 7th ed. As a rule, no foreign body is identified and all histochemical stains and cultures for infection are negative. This infection-related cutaneous condition article is a stub.
Erythema induratum – Wikipedia
Etiology Pathophysiology Erythema induratum is classified as a tuberculid or a chronic nodular skin eruption that represents a cutaneous hypersensitivity reaction to disseminated M tuberculosis MTB or its antigens.
Create a free personal account indurxtum download free article PDFs, sign up for alerts, customize your interests, and more. Actinomyces israelii Actinomycosis Cutaneous actinomycosis Tropheryma whipplei Whipple’s disease Arcanobacterium haemolyticum Arcanobacterium haemolyticum infection Actinomyces gerencseriae.
This page was last edited on 9 Julyat The prognosis of erythema induratum is excellent with appropriate treatment. Treatment Options Treatment options for erythema induratum are summarized in Table I.
Historical context Until recently, clinicians long debated the pathogenesis of EIB and the aforementioned association with Mycobacterium tuberculosis. Acquired partial lipodystrophy Centrifugal abdominal lipodystrophy HIV-associated lipodystrophy Lipoatrophia annularis localized: Although less well studied, potassium iodide, dapsone, gold salts, and doxycycline have also been used with success in the treatment of erythema induratum.
Entities currently considered tuberculids include erythema induratum of Bazin, lichen scrofulosorum, papulonecrotic tuberculid and most cases of granulomatous phlebitis. Currently, erythema induratum and nodular vasculitis are thought to result from a common inflammatory pathway, that is, a hypersensitivity to M tuberculosis MTB or non-MTB related antigens. The exact diagnosis is obscured by the fact that a number of pathologic processes can cause a similar clinical picture, eg, perniones or lupus erythematosus.