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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Lobular without vasculitis Cold Cytophagic histiocytic Factitial Gouty Pancreatic Traumatic needle-shaped clefts Subcutaneous fat necrosis of the newborn Sclerema neonatorum Post-steroid panniculitis Lipodermatosclerosis Weber—Christian disease Lupus erythematosus panniculitis Sclerosing lipogranuloma with vasculitis: It occurs mainly in women, but it is very rare now.
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Create a free personal account to access your subscriptions, sign up for alerts, and more. Serological studies including antistreptolysin titer O, hepatitis A, and B, Mycoplasma, Bartonella, and Epstein-Barr virus may additionally be positive.
Register for email alerts with links to free full-text articles Access PDFs of free articles Manage your interests Save searches and receive search alerts. 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. Actinomyces israelii Actinomycosis Cutaneous actinomycosis Tropheryma whipplei Whipple’s disease Arcanobacterium haemolyticum Arcanobacterium haemolyticum infection Actinomyces gerencseriae.
Get free access to newly published articles. In patients with moderate to severe symptoms, encourage the use of combination medical and physical modalities for potential synergistic effects. Individuals with EIB often demonstrate an exaggerated host immunologic response to the purified protein derivative that can result in a bullous type IV hypersensitivity reaction. Purchase access Subscribe now. 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.
Who is at Risk for Developing this Disease? Corynebacterium diphtheriae Diphtheria Corynebacterium minutissimum Erythrasma Corynebacterium jeikeium Group JK corynebacterium sepsis.
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Sign in to customize your interests Sign in to your personal account. What you should be alert for in the history Erythema induratum eritemw 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.
The ankle skin becomes sensitive to temperature changes. Patients with active disease require co-management with appropriate specialists. No pathognomonic histologic feature of erythema induratum exists, and histologic findings may vary with the age of the lesion Figure 2.
Although less well studied, potassium iodide, dapsone, gold salts, and doxycycline have also been used with success in the treatment of erythema inuratum. Erythema induratum is classified as a tuberculid or a chronic nodular skin eruption that represents a cutaneous hypersensitivity reaction to disseminated Vazin tuberculosis MTB or its antigens.
If negative, this should be followed up in weeks with the standard 5TU per 0.
You must be a registered member of Dermatology Advisor to post a comment. 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.
Erythema Induratum (Erythema induratum of Bazin, Nodular Vasculitis)
Alpha-1 antitrypsin deficiency panniculitis Erythema nodosum Acute Chronic with vasculitis: Create a free personal account to download free eritemq PDFs, sign up for alerts, and more. J Am Acad Dermatol. Feiwel, M, Munro, DD. Entities currently considered tuberculids include erythema induratum of Bazin, lichen scrofulosorum, papulonecrotic tuberculid and most cases of granulomatous phlebitis.
Erythema induratum classically presents during early adolescence and peri-menopause as subcutaneous poorly defined erythematous plaques and tender violaceous nodules.
Erythema induratum – Wikipedia
Predisposing factors include abnormal amount of subcutaneous fat, thick ankles and abnormally poor arterial supply. Less commonly, lesions may appear on the thighs, buttocks, arms and rarely the face and ears. Congenital generalized indurstum Familial partial lipodystrophy Marfanoid—progeroid—lipodystrophy syndrome Poland syndrome.
Page and Actinomycetaceae Actinomyces israelii Actinomycosis Cutaneous actinomycosis Tropheryma whipplei Whipple’s disease Arcanobacterium haemolyticum Arcanobacterium haemolyticum infection Actinomyces gerencseriae.
Other Early morning sputum, urine and gastric aspirates may be helpful to rule out an underlying active infection, but are generally knduratum. You can help Wikipedia by expanding it.
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.
Caseation necrosis is a late finding evident in approximately one half of cases. Fresh crops of nodules appear in periphery of ulcer and ultimately break down. Erythema nodusum differentiated clinically by the location on the hazin lower extremities, compared to the more characteristic posterior-lateral aspects of the legs of EIB and tendency towards spontaneous healing without ulceration or scarring.
Purchase access Subscribe to the journal. Sign in to make a comment Sign in to your personal account. Patients with active disease require more aggressive follow up and may warrant treatment with directly observed therapy DOT if there is any concern for noncompliance.
Patients may seemingly have no risk factors for prior TB exposure, and be otherwise completely healthy. There is still no consensus as to whether venules, larger septal veins, or arterioles are most typically involved.