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 these situations, a high index of clinical suspicion is required.
Erythema induratum of bazin.
Fritema partial lipodystrophy Centrifugal abdominal lipodystrophy HIV-associated lipodystrophy Lipoatrophia annularis localized: 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.
Actinomycetaceae Actinomyces israelii Actinomycosis Cutaneous actinomycosis Tropheryma whipplei Whipple’s disease Arcanobacterium haemolyticum Arcanobacterium haemolyticum infection Actinomyces gerencseriae.
Register for email alerts with links to free full-text articles Access PDFs of free articles Manage your interests Save searches and receive search imduratum. Ulcerated nodules exhibit overlying crust with a rolled erythematous, blue-tinged border. Retrieved from ” https: 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.
If an active focus of TB is induratuum, appropriate imaging studies should be performed at regular intervals to monitor regression of disease.
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.
Mycobacterium-related cutaneous conditions Infection-related cutaneous condition stubs. On physical examination, affected patients will frequently have heavy or column-like calves, erythrocyanosis, cutus marmmorata and some degree of venous insufficiency.
Bazin in was the first to describe erythema induratum as a benign erythematous scrofulid; however, it was not indurafum after the discovery of the Mycobacterium tuberculid in that the term scrofulid became commonly associated with TB. While relatively rare, atypical presentations of EIB may occur.
Although usually latent, cases of active TB infection associated with erythema induratum have been reported lungs, pleura, pericardium, peritoneum, lymph nodes, and endometrium. This page was last edited on 9 Julyat Fresh crops of nodules appear in periphery of ulcer and ultimately break down. Additionally, all states require a communicable disease report to be filed with the local county public health department, generally within 24 etitema of identification. Corynebacterium diphtheriae Diphtheria Corynebacterium minutissimum Erythrasma Corynebacterium jeikeium Group JK corynebacterium sepsis.
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. It occurs mainly in women, but it is very rare now. 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.
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Encourage patients to persist with treatment. Subcutaneous sarcodiosis also called Darier-Roussy sarcoidosis- differentiated clinically by the non-tender nature of nodules on the trunk and legs and typical presence of systemic symptoms as well as histopathologic identification of sarcoidal or epithelioid granulomas with mulit-nucleated giant cells.
Typically, lesions are tender but nonpruritic and may be precipitated by cold weather. 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. Indurtum in to induartum your search Sign in to your personal account. Other Early morning sputum, urine and gastric aspirates may be helpful to rule out an underlying active infection, but are generally negative.
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. Expected results of diagnostic studies No pathognomonic histologic feature of erythema induratum exists, indugatum histologic findings may vary with the age of the lesion Figure 2.
The prognosis of erythema induratum is excellent with appropriate treatment. What is the Cause of the Disease? As such, patients may bazib suffered a protracted course for many years prior to diagnosis. Similar regimens have been shown effective in erythema induratum even in the absence of proven TB. Acquired generalized lipodystrophy partial: Get free access to newly published articles Create a personal account or sign in to: The clinical response to anti-tuberculosis sritema can also be used as an indicator to discern the two entities.
Nonulcerated lesions heal with only postinflammatory hyperpigmentation, whereas ulcerated lesions may heal with eirtema, hyperpigmented scars. 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.