AN UNUSUAL MANIFESTATION OF LATENT TUBERCULOSIS INFECTION: ERYTHEMA INDURATUM OF BAZIN

Abstract

Erythema induratum of Bazin is characterized by tender, erythematous to violaceous subcutaneous nodules that usually occur on the lower legs. Currently the terms EIB and nodular vasculitis are often used as synonyms to describe this most common type of lobular panniculitis. However, some investigators still prefer the name EIB for those cases associated with tuberculosis infection. We describe 5 consecutive cases of EIB presented in the last seven months beginning from winter 2009 to autumn 2010. All patients had tender, erythematous to violaceous nodules on the lower legs. One patient had a history of a long- term cough one year ago, whereas 4 had a positive family history for tuberculosis. Tissue polymerase chain reaction were studied for 2 patients and revealed positive results while interferon-γ releasing assay resulted positive in all of the 4 patients tested. In addition, tuberculin skin test which was applied to 3 patients resulted with 15 mm, 20 mm, and 25 mm indurations. We found it suprising and worth mentioning that in the last 7 months, 5 consecutive patients who sought medical advice for tender, erythematous nodules on the lower legs appeared to have the diagnosis of EIB. Detailed personal and family history for tuberculosis infection was the most important clue that led to the diagnosis of EIB. In the light of these 5 cases, we would like to remind EIB which has to be kept in mind in the differential diagnosis of the patients with panniculitis like lesions especially in endemic areas for tuberculosis.

Keywords

• Erythema induratum of Bazin,tuberculosis,unusual manifestation

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