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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Patients may or may not recall a history of tuberculosis infection or exposure. InWhitfield el al. As such, once a diagnosis of a tuberculid is made, a thorough investigation to evaluate for subclinical or active TB infection should be pursued.
Laboratory tests Additional laboratory tests including a complete blood indruatum with differential, chemistry panel, erythrocyte sedimentation rate, and liver function tests are typically normal in erythema induratum. It is now considered a panniculitis that is not associated with just a single defined pathogen. Sign in to access your subscriptions Sign in to your personal account.
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There is a strong female predominance of the disease Sign in to customize your interests Sign in to your personal account. Regular follow up at week intervals is recommended during the active treatment period ineuratum ensure clearance of the lesions.
The diagnosis of erythema induratum is clinicopathologic with no pathognomonic histologic features. Robbins and Cotran pathologic basis of disease 7th ed.
J Am Inruratum Dermatol.
Erythema induratum – Wikipedia
Feiwel, M, Munro, DD. You can help Wikipedia by expanding it.
Chilblains may be present. Erythema induratum classically presents during early adolescence and peri-menopause as subcutaneous poorly defined erythematous plaques and tender violaceous nodules. Patients may describe a prolonged history of recurrent episodes over years or decades with new crops of lesions appearing often unpredictably. Corynebacterium diphtheriae Diphtheria Corynebacterium eritea Erythrasma Corynebacterium jeikeium Group JK corynebacterium sepsis. Page and The prognosis of erythema induratum is excellent with appropriate treatment.
Create a personal account to register for email alerts with links to free full-text articles. Risk factors 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. In patients with moderate to severe symptoms, encourage the use of combination indhratum 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.
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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. D ICD – Patients with active disease require co-management with appropriate specialists.
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There is still no consensus as to whether venules, larger septal veins, or arterioles are most typically involved. Individual lesions typically heal slowly over the course of several months, but may persist for years without appropriate treatment. Create a free personal account to download free article PDFs, sign up for alerts, and more. Additional laboratory tests including a complete blood count with differential, chemistry panel, erythrocyte sedimentation rate, and liver function tests are typically normal in erythema induratum.
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. The disease can masquerade as numerous chronic nodular conditions and the diagnosis can easily eritemw missed. Patients will likely need to be co-managed with an infectious disease physician to monitor the response to therapy.
Early lesions 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 gazin TB infection.