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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Similar regimens have been shown effective in erythema induratum even in the absence of proven TB. Which of the following best describes your experience with hand-foot-and-mouth disease? Who is at Onduratum for Developing this Disease? While there are no risk factors other than previous exposure to TB per se, cold hazin, venous stasis with poor peripheral blood flow and obesity appear to precipitate the development of lesions.
The diagnosis of erythema induratum is clinicopathologic with no pathognomonic histologic features.
Erythema Induratum (Erythema induratum of Bazin, Nodular Vasculitis)
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.
Diagnosis erutema Clinically, EIB can mimic a number of conditions presenting as lower extremity nodules, including: 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.
Nonsteroidal antiinflammatory agents NSAIDS may alleviate discomfort associated with nodular or ulcerated lesions and should also be considered. Sign in to customize your interests Sign in to your personal account. You can help Wikipedia by expanding it. If negative, this should be followed up in weeks with the standard 5TU per 0.
In these situations, a high index of clinical suspicion is required.
Although less well studied, potassium iodide, dapsone, gold salts, and doxycycline have also been used with success in the treatment of erythema induratum. The ankle skin becomes sensitive to temperature changes.
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. Although usually latent, cases of inxuratum TB infection associated with erythema induratum have been reported lungs, pleura, pericardium, peritoneum, lymph nodes, and jnduratum.
Erythema nodusum differentiated clinically by the location on the anterior lower extremities, compared to the more characteristic posterior-lateral aspects of the legs of EIB and tendency towards spontaneous healing without ulceration or scarring.
Congenital generalized lipodystrophy Familial partial lipodystrophy Marfanoid—progeroid—lipodystrophy syndrome Poland syndrome. Patients may describe a prolonged history of recurrent episodes over years or decades with new crops of lesions appearing often unpredictably.
The clinical response to anti-tuberculosis therapy can also be used as an indicator to discern the two entities. Early morning sputum, urine and gastric aspirates may be helpful to rule out an underlying active infection, but are generally negative. The plaques are generally erythematous and indurated, with an overlying scaly surface, and may or may not be tender to deep palpation.
From Wikipedia, the free encyclopedia. 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. Regular follow up at week intervals is recommended during the active treatment period to ensure clearance of the lesions.
There is still no consensus as to whether venules, larger septal veins, or arterioles are most typically involved. Purchase indutatum Subscribe to the journal.
Nodules are typically cm in size, erythematous to violaceous in color, and have a tendency to ulcerate centrally. As such, patients may have suffered a protracted course for many years prior to diagnosis.
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Sign in to save your search Sign incuratum to your personal account. It occurs mainly in women, but it is very rare now. 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.
Historical context Until recently, clinicians long debated the pathogenesis of EIB and the aforementioned association with Mycobacterium tuberculosis.
Erythema induratum – Wikipedia
Entities currently considered tuberculids include erythema induratum of Bazin, lichen scrofulosorum, papulonecrotic tuberculid and most cases of granulomatous phlebitis. No sponsor or advertiser has participated in, approved or paid for the content provided by Decision Support in Medicine LLC.
No pathognomonic histologic feature of erythema induratum exists, and histologic findings may vary eritemma the age of the lesion Figure 2. Feiwel, M, Munro, DD.
Erythema induratum classically presents during early adolescence and peri-menopause as subcutaneous poorly defined erythematous plaques and tender violaceous nodules. Fresh crops of nodules appear in periphery of ulcer and ultimately break down.
Caseation necrosis is a late finding evident in approximately one half of cases. Abnormal arterial supply causes low-grade ischemia of ankle region. Get free access to newly published articles Create a eritemq account or sign in to: Hong Kong Med J.
Histology will demonstrate a lobular panniculitis with ghost adipoyctes adipocytes with fine granular basophilic material and no nuclei and necrosis of adipocytes. On physical examination, affected patients will frequently have heavy or column-like calves, erythrocyanosis, cutus marmmorata and some degree of venous insufficiency. Sign in to make a comment Sign in to your personal account.
Mycobacterium-related cutaneous conditions Infection-related cutaneous condition stubs.
Bazin in was the first to describe erythema induratum as a benign erythematous scrofulid; however, it was not until after the discovery of the Mycobacterium tuberculid in that the term scrofulid became commonly associated with TB.
Basic CDC recommendations for the common four drug therapy bazib listed below. Corynebacterium diphtheriae Diphtheria Corynebacterium minutissimum Bszin Corynebacterium jeikeium Group JK corynebacterium sepsis. Men and even young children may present with the disease, and lesions may appear in unusual locations including the feet, buttocks, thighs, arms and rarely the face and ears.