| Four patients with erythema induratum (EI) have been diagnosed at the dermatology Department within the past two years. All four patients had a history of recurrent painful nodules on their calves for at least three years before diagnosis. Three of the patients, all with positive Mantoux reaction to tuberculin skin tests, had neither a personal or family history of tuberculosis. The other patient who had a six year history of recurrent painful leg nodules developed a tuberculous breast abscess. There was a dramatic response to anti-tuberculous chemotherapy in all four patients but one subsequently had recurrent nodules which spontaneously subsided without further chemotherapy. ( info) |
| A patient with nodular vasculitis was treated successfully with oral gold. This therapy is safe and devoid of significant side effects. The rationale and advantages of the use of oral gold in patients with nodular vasculitis are discussed. ( info) |
13/25. Mycobacterial subcutaneous arteritis. The authors report three patients with subcutaneous erythematous nodules in different phases of development, unspecific systemic symptoms, positive PPD test, and normal chest x-rays. The histopathological study of the older nodules showed a granulomatous arteritis with a few acid-fast bacilli in the vascular wall. The nodules at an early phase showed an unspecific panniculitis with some acid-fast bacilli in apparently normal cutaneous vessels. These findings suggest that the mycobacterium has a vascular tropism and may cause a primary granulomatous arteritis. ( info) |
14/25. erythema induratum of Bazin as a type of tuberculid. We report three cases of patients with erythema induratum of Bazin who showed extreme tuberculin hypersensitivity reactions and a good therapeutic response to isoniazid. In the first patient satellite lesions with epithelioid granuloma formation developed 3 weeks after injection of purified protein derivative. In the second patient a high fever developed 1 day after injection of purified protein derivative, and the third patient blistered at the injection site; the histopathologic pattern was similar to erythema multiforme. Immunohistologic study of the epithelioid granulomas demonstrated a predominance of Leu-1--bearing, Leu-3a--bearing, and human lymphocyte antigen-DR-expressing cells. We conclude that erythema induratum of Bazin represents a tuberculid caused by heightened delayed-type hypersensitivity to components of tubercle bacilli released from latent foci of infection. ( info) |
15/25. Two tuberculides in one patient--a case report of papulonecrotic tuberculide and erythema induratum occurring together. A patient is described in whom erythema induratum and papulonecrotic tuberculide occurred simultaneously. Clinical and histological appearances were characteristic as was the response to antituberculous chemotherapy. ( info) |
| We report erythema induratum in a patient who was found to have active endometrial tuberculosis. This case report emphasizes the importance of an exhaustive search for active tuberculosis in patients with erythema induratum, especially in countries where tuberculosis is prevalent, as the indiscriminate treatment of erythema induratum with steroids may be harmful. ( info) |
| The etiology of erythema induratum, a rare disease of the skin in the united states but occasionally seen in natives of Asian countries, remains a source of debate. Its association with tuberculosis, although strongly suspected for more than one century, has not been clearly defined. We report a case of erythema induratum occurring in a young Chinese woman in the setting of active pulmonary tuberculosis. Both diseases promptly responded to antituberculous therapy. The diagnosis of erythema induratum should urge the clinician to search for a source of active tuberculosis, and treatment should be initiated accordingly. ( info) |
| erythema induratum of Bazin is a rare entity, the cause and treatment of which are topics of continuing controversy. This report documents the cases of two patients with ulcerating leg nodules. One patient had concurrent active pulmonary tuberculosis, and the other had a history of previous treatment for pulmonary tuberculosis. The treatment regimen for these patients is outlined. First described by Bazin, the rare entity of erythema induratum was thought to be of tuberculous origin or a tuberculid reaction. Opinion has varied, and some authors have classified this condition as a vasculitis involving subcutaneous vessels. Because of the rarity of this disorder and the controversy surrounding its cause and pathogenesis, we share our experience with two patients whose clinical and pathologic findings were consistent with the diagnostic criteria for erythema induratum and in whom there was a recent or remote history of tuberculosis. ( info) |
| Three cases of erythema induratum which occurred in the patients with pulmonary tuberculosis are described. The cutaneous lesions were violaceous, indurated nodules on both lower legs above the malleoli. Histologically, tuberculoid granuloma with caseation necrosis was found in one case; necrotizing vasculitis was the prominent finding in other two cases. The erythema induratum promptly responded to antituberculous therapy. We believe that, in light of these cases, the association between erythema induratum and infection with tubercle bacilli should be re-emphasized. ( info) |
| A 44-year-old Japanese woman with primary tuberculosis of the nasopharynx associated with erythema induratum of Bazin (EI) is reported. The patient presented with erythematous nodules of the lower legs diagnosed as EI. Since EI is a tuberculosis-related skin disease, the presence of latent tuberculous lesions was investigated, and a tuberculous lesion was found in the nasopharynx. Primary tuberculosis of the nasopharynx is very rare. Furthermore, our review of the literature revealed no case in which nasopharyngeal tuberculosis acted as the latent focus of EI. ( info) |