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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In patients with moderate to severe symptoms, encourage the use of combination medical and physical modalities for potential synergistic effects. As such, once a diagnosis of a tuberculid is made, a thorough investigation to evaluate for subclinical or active TB infection should be pursued.

For patients with latent disease and multiple co-morbidities, the risks of systemic antituberculosis therapy should be carefully weighed against the benefits. Create a free personal account to download free article PDFs, sign up for alerts, customize your interests, and more.

Corynebacterium diphtheriae Diphtheria Corynebacterium minutissimum Erythrasma Corynebacterium jeikeium Group JK corynebacterium sepsis. Erythema induratum classically presents during early adolescence and peri-menopause as subcutaneous poorly defined erythematous plaques and tender violaceous nodules. Although usually latent, cases of active TB infection associated with erythema induratum have been reported lungs, pleura, pericardium, peritoneum, lymph nodes, and endometrium.

A good rule of thumb is, if a patient presents with chronic, relapsing, ulcerating nodules demonstrating mostly lobular panniculitis, an assessment for latent and active TB is warranted. Tuberculoid leprosy Borderline tuberculoid leprosy Borderline leprosy Borderline lepromatous leprosy Lepromatous leprosy Histoid leprosy. 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.

You can help Wikipedia by expanding it. 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 fat.


Retrieved from ” https: Historically, when it has occurred, it has often been concomitant with cutaneous tuberculosisand it was formerly thought to be always a reaction to the tuberculum bacillus.

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Sign in to download free article PDFs Sign in to access your subscriptions Sign in to your personal account. InWhitfield el al. 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.

Affected patients are thought to possess a strong anti-MTB cell-mediated immunity. The plaques are generally erythematous and indurated, with an overlying scaly surface, and may or may not be tender to deep palpation.

Acquired generalized lipodystrophy partial: Create a free personal account to access basin subscriptions, sign up for alerts, and more.

Alpha-1 antitrypsin deficiency panniculitis Erythema nodosum Acute Chronic with vasculitis: Nonsteroidal antiinflammatory agents NSAIDS may alleviate discomfort associated with nodular or ulcerated lesions and should also be considered. Compression stockings or supportive bandages can result in improvement of lesions and may warrant a trial in patients with editema disease prior to advancing to systemic treatment.

Create a personal account to register for email alerts with links to free full-text articles. 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. There is still no consensus as to whether venules, larger septal veins, or arterioles are most typically involved.

Risk factors While there are no baxin factors other than previous exposure to TB per se, cold weather, venous stasis with poor peripheral blood flow and obesity appear to precipitate the development of lesions. If negative, this should be followed up in weeks with the standard 5TU per 0. Early indurstum are generally confined to the subcutaneous fat lobular inflammation and display a predominantly lymphocytic infiltrate, whereas later lesions may extend into the deep dermis and display noncaseating granulomas typical of TB infection.


Erythema induratum of bazin.

You can help by adding to it. Create a free personal account to make a comment, download free article PDFs, sign up for alerts and more. No pathognomonic histologic feature of erythema induratum exists, and histologic findings may bazinn with the age of the lesion Figure 2. On palpation dritema, small superficial and painful nodules are felt. In hot weather, ankle becomes hot, edematous, swollen and painful. Patients may seemingly have no risk factors for prior TB exposure, and be otherwise completely healthy.

Pancreatic panniculitis differentiated clinically by temporal relationship to pancreatic pathology and spontaneous oily brown discharge from lesions due to liquefactive necrosis.

Basic CDC recommendations for the common indurtum drug therapy are listed below. We describe a patient with El in whom the diagnosis of tuberculosis could be established by the detection of mycobacterial DNA in a lesional biopsy specimen using the polymerase chain reaction PCR.

While there are no risk factors other than previous exposure to TB per se, cold weather, venous stasis with poor peripheral blood flow and obesity appear to precipitate the development of lesions. The clinical response to anti-tuberculosis therapy can also be used as an indicator to discern the two entities.

Erythema Induratum (Erythema induratum of Bazin, Nodular Vasculitis)

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.

By registering you consent to the collection and use of your information to provide the products and services you have requested from us and as described in our privacy policy and terms and conditions. Erythema nodusum differentiated clinically by the location on the anterior lower extremities, writema to the more characteristic posterior-lateral aspects of the legs of EIB and tendency towards spontaneous healing without ulceration or scarring.

When weather is cold, ankle is cold, blue and often tender.