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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The ankle skin becomes sensitive to temperature changes. Currently, the CDC recommends a 6-month, four-drug course with 2 months or RIPE rifampin, isoniazid, pyrazinamide, ethambutolfollowed by 4 months of isoniazid. Privacy Policy Terms of Use.

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 also 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. Purchase access Subscribe to JN Learning for one year.

Explain to the patient the importance of compliance with anti-tuberculosis treatment before beginning therapy. Cutaneous polyarteritis nodosa differentiated clinically by lesions location- typically along medium sized arteries and pressure points; ie.

Basic CDC recommendations for the common four eritwma therapy are listed below. Rritema patients to persist with treatment. Until recently, clinicians long debated the pathogenesis of EIB and the aforementioned association with Mycobacterium tuberculosis. Although usually latent, cases of active TB infection associated with erythema induratum have been reported lungs, pleura, pericardium, peritoneum, lymph nodes, and endometrium.

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Actinobacteria primarily A00—A79—, — Patients will likely need to be co-managed with an infectious disease physician to monitor the response to therapy. This infection-related cutaneous condition article is a stub. Less commonly, lesions may appear on the thighs, buttocks, arms and rarely the face and ears. Clinically, EIB can mimic a number of conditions presenting as lower extremity nodules, including:.

Subsequent authors questioned the causal relationship between EIB and TB, citing the lack of ertiema granulomas or acid-fast bacilli in lesional biopsies of EIB; patients and the inability to induce tuberculosis lesions in guinea pigs by inoculation.

Active TB infections should be treated more aggressively than latent infections. No sponsor or advertiser has participated erifema, approved or paid for the content provided by Decision Support in Medicine LLC. Diagnosis confirmation Clinically, EIB can mimic a number of conditions presenting as lower extremity nodules, including: Histology eriteam demonstrate a indurxtum panniculitis with ghost adipoyctes adipocytes bxzin fine granular basophilic material and no nuclei and necrosis of adipocytes.

Erythema Induratum (Erythema induratum of Bazin, Nodular Vasculitis)

Erythema induratum is classified as a tuberculid or a chronic nodular skin eruption that represents a indhratum hypersensitivity reaction to disseminated M tuberculosis MTB or its antigens. If an active focus of TB is uncovered, appropriate imaging studies should be performed at regular intervals to monitor regression of disease.

Subcutaneous nodule with overlying poorly defined violaceous erythema on the posterior leg The plaques are generally erythematous and indurated, with an overlying scaly surface, sritema may or may not be tender to deep palpation.

Even if an association with tuberculosis is assumed, the decision to start antituberculosis chemotherapy cannot be based on the diagnostic criteria required for the diagnosis of tuberculosis, eg, culture and microscopic detection of acid-fast bacilli.

Additional laboratory induuratum including a ertiema blood count with differential, chemistry panel, erythrocyte sedimentation rate, and liver function tests are typically normal in erythema induratum. There is still no consensus as to whether venules, larger septal veins, or arterioles are most typically involved. Nonulcerated lesions heal with only postinflammatory hyperpigmentation, whereas ulcerated lesions may heal with atrophic, hyperpigmented scars.

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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. 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.

Caseation necrosis is a late finding evident in approximately one half of cases. Early lesions are generally confined to eritea subcutaneous fat lobular inflammation and display a predominantly lymphocytic infiltrate, whereas later lesions may extend into the deep dermis and display noncaseating granulomas typical of TB infection.

Erythema Induratum (Erythema induratum of Bazin, Nodular Vasculitis)

Systemic Implications and Complications Although usually latent, cases of active TB infection associated with erythema induratum have been reported lungs, pleura, pericardium, peritoneum, lymph nodes, and endometrium.

Corynebacterium diphtheriae Diphtheria Corynebacterium minutissimum Erythrasma Corynebacterium jeikeium Group JK corynebacterium sepsis. Actinomyces israelii Actinomycosis Cutaneous actinomycosis Tropheryma whipplei Whipple’s disease Arcanobacterium haemolyticum Arcanobacterium haemolyticum infection Actinomyces gerencseriae. What is the Cause of the Disease?

Create a personal account to register for email alerts with links to free full-text articles. Lupus profundus also known as lupus panniculitis, differentiated clinically by its more characteristic location on the face and tendency to cause lipodystrophy due to complete destruction of the involved fat cells.

Erythema induratum is characterized by painful, erythematous, sometimes ulcerating nodules on the lower legs that, histopathologically, show a lobular panniculitis.