The histopathologic spectrum of erythema induratum of Bazin

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dc.contributor.authorSchneider J.W.
dc.contributor.authorJordaan H.F.
dc.date.accessioned2011-05-15T16:15:18Z
dc.date.available2011-05-15T16:15:18Z
dc.date.issued1997
dc.description.abstractErythema induratum of Bazin is a tuberculid that is strongly associated with tuberculosis. Clinically, erythema induratum of Bazin shows recurrent tender subcutaneous nodules that occur mainly on the calves of women with tuberculin hypersensitivity. Previous studies have not documented the histopathologic spectrum of erythema induratum of Bazin in detail. We identified two major histopathologic groups in 19 of 20 skin biopsies obtained from 20 patients with well-documented erythema induratum of Bazin. Six cases (group I) showed focal septolobular panniculitis in close association with a single muscular artery or small vessel with primary neutrophilic vasculitis. Thirteen cases (group II) revealed diffuse septolobular panniculitis with primary neutrophilic vasculitis of either large or smaller vessels. Both groups showed varying combinations and degrees of acute and chronic inflammation, coagulative and caseation-like necrosis, and granulomatous inflammation. Poorly developed granulomas predominated, but mixed, palisading, and lipophagic granulomas also occurred. Inflammation and necrosis were more extensive in group II. Erythema induratum of Bazin may show predominantly acute suppurative or granulomatous panniculitis. Immunostaining showed S100+ antigen-presenting cells, macrophages, and T- lymphocytes. B-lymphocytes were rare. The presence of primary vasculitis and granulomas suggests that types III and IV hypersensitivity reactions play a role in the pathogenesis of erythema induratum of Bazin. The latter remains a clinicopathologic diagnosis, but awareness of the heterogeneous histopathologic spectrum of EIB will ensure a timely diagnosis and institution of antituberculous treatment.
dc.description.versionArticle
dc.identifier.citationAmerican Journal of Dermatopathology
dc.identifier.citation19
dc.identifier.citation4
dc.identifier.issn01931091
dc.identifier.other10.1097/00000372-199708000-00003
dc.identifier.urihttp://hdl.handle.net/10019.1/13280
dc.subjectantigen presentation
dc.subjectarticle
dc.subjectdelayed hypersensitivity
dc.subjectgranulomatous inflammation
dc.subjecthistopathology
dc.subjecthuman
dc.subjecthuman tissue
dc.subjectmycobacterium tuberculosis
dc.subjectnecrosis
dc.subjectpanniculitis
dc.subjectpriority journal
dc.subjectskin biopsy
dc.subjectskin tuberculosis
dc.subjectsubcutaneous nodule
dc.subjectAdolescent
dc.subjectAdult
dc.subjectAntigen-Presenting Cells
dc.subjectArteries
dc.subjectB-Lymphocytes
dc.subjectBiopsy
dc.subjectColoring Agents
dc.subjectDiagnosis, Differential
dc.subjectErythema Induratum
dc.subjectFemale
dc.subjectGranuloma
dc.subjectHumans
dc.subjectHypersensitivity
dc.subjectImmunoenzyme Techniques
dc.subjectInflammation
dc.subjectLeg Dermatoses
dc.subjectLipids
dc.subjectMacrophages
dc.subjectMicrocirculation
dc.subjectMiddle Aged
dc.subjectMuscle, Skeletal
dc.subjectNecrosis
dc.subjectNeutrophils
dc.subjectPanniculitis
dc.subjectRecurrence
dc.subjectS100 Proteins
dc.subjectSuppuration
dc.subjectT-Lymphocytes
dc.subjectTuberculosis, Cutaneous
dc.subjectVasculitis
dc.titleThe histopathologic spectrum of erythema induratum of Bazin
dc.typeArticle
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