Erythema Induratum (EI) more often affects middle-aged women [1], but men and children can also acquire this illness.

An EI case usually suffers from pulmonary tuberculosis, but other sites of infection, like cervical lymphadenitis [2], renal parenchyma [3], epididymo-orchitis [4] or aortic valvular lesions of the same etiology [5] are possible. One study [6] even describes EI after Bacillus Calmette–Guérin (BCG) vaccine administration. In addition, it is important to evaluate the existence of human immunodeficiency virus (HIV) concomitant infection clinical traits [7].

The patients show erythematous or violaceous nodules, 1 - 4 cm in size, or plaques with a scaly surface located on the lower limbs, that may be tender and have a recurrent character, reappearing once every 3 or 4 months. Nodules sometimes cause shallow ulcers that heal, leaving scars and hyper pigmented areas. The affected regions, like calves, ankles, thighs, buttocks, but also trunk and arms are edematous. Disseminated forms have been described [8]. Pruritus is absent. The disease may worsen with cold weather. The clinical picture may be completed by the presence of distal painful peripheral neuropathy [9], cutis marmorata or erythrocyanosis. Systemic complaints are usually absent, but other dermal manifestations of tuberculosis, such as papulonecrotic tuberculids may coexist.

• Collapse

  […] inflammation with pontine perivascular enhancement responsive to steroids 脳橋周囲血管を伴う慢性リンパ球性炎症 ステロイドに反応する増強 3 Chronic recurrent multifocal osteomyelitis 慢性再発性多巣性骨髄炎 3 Chronic respiratory failure 慢性的な呼吸不全 3 Chronic spontaneous urticaria 慢性自然蕁麻疹 3 Circulatory collapse [ikenori.com]

• Fishing

  Article CAS PubMed Google Scholar Weber HC, Beyers N, Gie RP, Schaaf HS, Fish T, Donald PR. The clinical and radiological features of tuberculosis in adolescents. Ann Trop Paediatr. 2000;20(1):5–10. https://doi.org/10.1080/02724930091995. [bmcinfectdis.biomedcentral.com]

• Cough

  She had recurring fevers particularly at night, lethargy, weight loss and a persistent non-productive cough. The Mantoux test was positive. [ncbi.nlm.nih.gov]

  Symptoms of TB in the lungs may include A bad cough that lasts 3 weeks or longer Weight loss Loss of appetite Coughing up blood or mucus Weakness or fatigue Fever Night sweats Skin tests, blood tests, x-rays, and other tests can tell if you have TB. [icdlist.com]

  If the patient has a cough, the doctor may order a sample of the cough ejected material for laboratory analysis. Tests for the diagnosis of sarcoidosis. [hickeysolution.com]

  There was no history of trauma, radiation exposure, vaccination, loss of weight, fever, cough, and family or personal history of tuberculosis. [e-ijd.org]

  He denied any history of fever, night sweats, weight loss, or cough. No past or family history of tuberculosis could be elicited. [ijdpdd.com]

• Vomiting

  The patient complained of nausea and vomiting 14 days after initiation of treatment and the blood platelet count was reduced to 20 × 109/L. [journals.lww.com]

  Often there are also systemic symptoms, including chills, fever, headache, vomiting, backache, and stiff neck. [medical-dictionary.thefreedictionary.com]

• Nausea

  The patient complained of nausea and vomiting 14 days after initiation of treatment and the blood platelet count was reduced to 20 × 109/L. [journals.lww.com]

  Adverse effects from salicylate toxicity include nausea, vomiting, confusion, dizziness, psychosis, stupor, coma, death, hypoglycemia, and tinnitus. Before oral steroids are administered, an underlying infection should be excluded. [clinicaladvisor.com]

• Thrombosis

  壊死性血管炎 9 Vena cava embolism 大静脈塞栓症 9 Vena cava thrombosis 大静脈血栓症 9 Venous intravasation 静脈内侵襲 9 Venous recanalisation 静脈の再疎通 9 Venous thrombosis 静脈血栓症 9 Venous thrombosis in pregnancy 妊娠中の静脈血栓症 9 Venous thrombosis limb 四肢静脈血栓症 9 Venous thrombosis neonatal [ikenori.com]

  In such nodules, an inflamed and thrombosed vein was surrounded by an area of panniculitis with simultaneous thrombosis of its venules (12). [journals.lww.com]

  Papulonecrotic tuberculid: lymphohistiocytic small vessel vasculitis with thrombosis, ulceration, and wedge-shaped necrosis. Lichen scrofulosorum: noncaseating peri-appendageal granulomas in the superficial dermis. [dermnetnz.org]

  In the later stages, there is intimal proliferation with thrombosis leading to ischemia and ulceration sometimes. [ijdpdd.com]

  Necrosis and thrombosis of septal small and larger vessels are evident, as well as small vessels not yet occluded and enveloped by dense lymphocyte coats. Focally, eosinophilic adipose tissue necrosis is visible. [altmeyers.org]

• Skin Lesion

  The skin lesions showed improvement at one month and remitted mostly at two months. After 6 months, the skin lesions have subsided and no obvious side effects were observed. [ncbi.nlm.nih.gov]

  Some skin lesions showed superficial ulcers on deep skin atrophy covered with crusts and scales (Figure 1). [dovepress.com]

  The histopathology of the skin lesion was suggestive of erythema induratum. She had complete resolution of her skin lesions and fever following 6 months of treatment with antitubercular drugs. [ijmyco.org]

• Skin Disease

  Since EI is a tuberculosis-related skin disease, the presence of latent tuberculous lesions was investigated, and a tuberculous lesion was found in the nasopharynx. Primary tuberculosis of the nasopharynx is very rare. [ncbi.nlm.nih.gov]

  Cutaneous tuberculosis was once a relatively common skin disease in Hong Kong. Tuberculosis verrucosa cutis was the… There is a group of diseases which involve primarily the legs, characterized by the presence of nodules and sometimes by… [semanticscholar.org]

  Erythema induratum represents a chronic skin disease most often caused by Mycobacterium tuberculosis, consisting of chronic inflammatory nodules commonly located on the lower limbs of the patient. [symptoma.com]

  David Weedon On DermNet NZ: Erythema nodosum Dermatopathology glossary Dermatopathology index Books about skin diseases: See the DermNet NZ bookstore [dermnetnz.org]

  Non-malignant skin disease. ↑ 1.0 1.1 1.2 Brinster, NK. (Nov 2008). "Dermatopathology for the surgical pathologist: a pattern-based approach to the diagnosis of inflammatory skin disorders (part II).". [librepathology.org]

• Urticaria

  Nevoid basal cell carcinoma syndrome 504 163 Nevus sebaceus 509 164 Notalgia paresthetica 511 165 Onchocerciasis 513 166 Oral lichen planus 516 167 Orf 519 168 Palmoplantar keratoderma 521 169 Palmoplantar pustulosis 524 170 Panniculitis 526 171 Papular urticaria [books.google.com]

  U UMBILICAL HERNIA (see HERNIA) UNILATERAL LATEROTHORACIC EXANTHEMA (ASYMMETRICAL PERIFLEXURAL EXANTHEM OF CHILDHOOD) URTICARIA URTICARIA, CHOLINERGIC URTICARIA PIGMENTOSA (MASTOCYTOSIS) V VAGINITIS VARICELLA (L. [euro-libris.ro]

  Updates Diseases & Conditions Acne Actinic Keratosis Aesthetic Dermatology Atopic Dermatitis Autoimmune Diseases Contact Dermatitis Hair & Nails Melanoma Nonmelanoma Skin Cancer Pigmentation Disorders Psoriasis Psoriatic Arthritis Rare Diseases Rosacea Urticaria [mdedge.com]

  + Progressive osseous heteroplasia + Gout, arthritis uratica + Hemosiderin + Argyrosis + Titanium pigmentation + Deposits of corticosteroids in the dermis + Ochronosis + Colloid milium + Subcutaneous emphysema + Tumorous infiltration of the corium + Urticaria [atlases.muni.cz]

• Pigmented Scar

  There was no discharge, ulceration, or scarring. The rest of the examination was unremarkable. Figure 1: Clinical photograph of skin lesion (a). [ijmyco.org]

  scars. [2], [12] However, we observed lesions resolving with hyperpigmentation within 2-12 weeks in 3 of 4 cases and ulceration occurring in one patient only. [ijdvl.com]

• Hematuria

  It has been done an urynalysis, which demonstrated acid pH urine, sterile pyuria and microscopic hematuria. It was then raised the diagnostic hypothesis of renal tuberculosis. [ncbi.nlm.nih.gov]

  The urynalysis showed an acid urine (pH = 5.5), sterile pyuria and microscopic hematuria (6 erythrocytes per high power field). [scielo.br]

  ICD-10-CM Diagnosis Code R31.21 Asymptomatic microscopic hematuria 2017 - New Code 2018 2019 2020 2021 2022 2023 Billable/Specific Code Amianthosis J61 ICD-10-CM Diagnosis Code J61 Pneumoconiosis due to asbestos and other mineral fibers 2016 2017 2018 [icd10data.com]

• Irritability

  The patient was initially treated with saturated solution of potassium iodide which led to partial improvement, but it had to be discontinued due to gastric irritation. [edoj.org.eg]

  […] indurated, I should turn new page from now on. ro Chemaţi imediat aici o echipă medicală en from the induration strand; and ro Chiar şi- atunci, puţini au fost cei care au clacat en Asthenia, peripheral oedema, injection site reactions (including pain, irritation [ro.glosbe.com]

  dermatitis, acute + Toxic contact (irritative) dermatitis, chronic + Seborrhoic dermatitis + Pityriasis amiantacea + Changes caused by rubbing, scratching and pressure + Lichen simplex + Strophulus + Prurigo gestationis + Prurigo nodularis + Prurigo [atlases.muni.cz]

  The prognosis It is important to note that erythema nodosum is not a threat to internal organs, even if it is irritating and often painful. In the long run, recovery is usually complete, although sometimes the disease is relapsing. [hickeysolution.com]

  Direct extension occurs when the infected material makes contact with the irritated skin or the breast ducts during lactation. The secondary form of the disease occurs more frequently. [jmedicalcasereports.biomedcentral.com]

• Neglect

  Papulonecrotic tuberculide: A neglected disease in Western countries. J Am Acad Dermatol. 1986; 14: 815-826 Scopus (65) PubMed Abstract Full Text PDF Google Scholar Champion RH Burton JL Ebling FJG 5th Edn. Textbook of Dermatology. [journalofinfection.com]

  Papulonecrotic tuberculid: A neglected disease in Western countries. J Am Acad Dermatol. 1986;14(5):815-26. doi: 10.1016/s0190-9622(86)70099-6. 10. Oon HH, Chong WS, Oh CC, Tan AW, Lee JS, Sen P, et al. [brieflands.com]

  Hemispatial neglect Left-sided neglect Sensory neglect Visuospatial neglect Type 1 Excludes visuospatial deficit (R41.842) Aspartylglucosaminuria E77.1 ICD-10-CM Diagnosis Code E77.1 Defects in glycoprotein degradation 2016 2017 2018 2019 2020 2021 2022 [icd10data.com]

• Agitation

  C Calcifiere în craniu - on-line - doar Candidoză ( CUTANAT ) Candidoza, orale (vezi afte) Cataracta, CONGENITALĂ celulita cefalhematom Pustuloză cefalic, benigne ( acnee nou-născut ) șalazion POX pui ( vezi varicela ) ABUZ ( TRAUMA nonaccidental ) AGITATE [euro-libris.ro]

  see condition Agitation R45.1 ICD-10-CM Diagnosis Code R45.1 Restlessness and agitation 2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code Aglossia Q38.3 (congenital) ICD-10-CM Diagnosis Code Q38.3 Other congenital malformations of tongue [icd10data.com]

• Hyperactivity

  Applicable To Arcuatus uterus Arcus (cornea) - see Degeneration, cornea, senile Areflexia R29.2 ICD-10-CM Diagnosis Code R29.2 Abnormal reflex 2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code Type 2 Excludes abnormal pupillary reflex (H57.0) hyperactive [icd10data.com]

Workup should include a complete cell blood count with differential, inflammatory markers (such as the erythrocyte sedimentation rate) and liver function tests. M. tuberculosis infection can be diagnosed in may ways: interferon-gamma release assays [10] such as QuantiFERON--tuberculosis (TB) Gold In-Tube test and the T-SPOT-TB test [11]. The manifestation of pathognomonic lesions and a positive QuantiFERON exam establish the diagnosis, even if acid-fast bacilli are not detected or the thoracic radiography is normal [12]. The purified protein derivative tuberculosis skin test is positive in these patients and an exaggerated host immunologic response and hypersensitivity reaction are to be expected after administration. In case an underlying active disease is suspected, the physician should order urine, early morning sputum, and gastric aspirates microbiological examination.

Imaging modalities include thoracic radiographs (posteroanterior and lateral) that may show aspects of active or inactive tuberculosis. If the diagnosis cannot be established otherwise, an excisional biopsy should be done. The tissue will then be analyzed using hematoxylin-eosin, specific stains for acid-fast bacilli, but also for bacteria and fungi. In cases with negative tuberculosis findings, hepatitis C and HIV infection should be searched for. Furthermore, a histological analysis will depict a granulomatous panniculitis with possible inflammatory vasculitis [13], noncaseating granulomas and caseation-like necrosis. Other cell types, like giant, epithelioid cells or histiocytes are also encountered in late stages, while fresh lesions mainly contain lymphocytes. The presence of M. tuberculosis deoxyribonucleic acid in the excised tissue can be proven using polymerase chain reaction [14]. However, its absence does not confirm the non-existence of the ailment.

• Albuminuria

  Heart Failure Importance: Only 1 class of glucose-lowering agents-sodium-glucose cotransporter 2 (SGLT2) inhibitors-has been reported to decrease the risk of cardiovascular events primarily by reducingSeptember 1, 2017: JAMA CardiologyAssociations of albuminuria [read.qxmd.com]

  albuminuric (acute) (chronic) (subacute) R80.9 - see also Proteinuria ICD-10-CM Diagnosis Code R80.9 Proteinuria, unspecified 2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code Applicable To Albuminuria NOS Albuminurophobia F40.298 ICD-10 [icd10data.com]

Potassium iodide is also an effective and rapid treatment for erythema induratum of Bazin. [dermaamin.com]

After treatment of any identified potential etiologies, therapeutic options are similar for both EIB and EN, which are forms of panniculitis. [unboundmedicine.com]

One patient had concurrent active pulmonary tuberculosis, and the other had a history of previous treatment for pulmonary tuberculosis. The treatment regimen for these patients is outlined. [ncbi.nlm.nih.gov]

In non-tuberculous type (Whitfield type), treatment of the associated (underlying) condition is necessary The prognosis of Erythema Induratum is good in a majority of cases. [dovemed.com]

Prognosis The prognosis is good if treated properly. To date, no fatal cases of erythema induratum have been reported. However, the chronic, recurrent, painful nodules and resultant scarring can be a source of significant morbidity. [emedicine.com]

Prognosis If TB is the cause, the lesions will disappear with appropriate TB treatment. Spontaneous resolution of lesions is common within a few months, leaving areas of postinflammatory hyperpigmentation and atrophic scarring. [patient.co.uk]

HISTORY PHYSICAL EXAM DIFFERENTIAL DIAGNOSIS DIAGNOSTIC TESTS & INTERPRETATION TREATMENT GENERAL MEASURES MEDICATION ISSUES FOR REFERRAL SURGERY/OTHER PROCEDURES ADMISSION, INPATIENT, AND NURSING CONSIDERATIONS ONGOING CARE FOLLOW-UP RECOMMENDATIONS DIET PROGNOSIS [5minuteconsult.com]

Some investigators, however, prefer to retain the name erythema induratum of Bazin for those cases in which an etiologic relationship with tuberculosis is demonstrated and refer to the remainder of cases as nodular vasculitis. [dermaamin.com]

After treatment of any identified potential etiologies, therapeutic options are similar for both EIB and EN, which are forms of panniculitis. [unboundmedicine.com]

In many countries, tuberculosis is still the main etiologic factor. We report a case of a 40-year-old woman who presented a course of protracted and recurrent episodes over five years of cutaneous lesions on her legs. [semanticscholar.org]

PCR amplification for the detection of mycobacterial DNA in the skin biopsy specimens is important in establishing a tubercular etiology. [edoj.org.eg]

The etiology of erythema induratum, a rare disease of the skin in the United States but occasionally seen in natives of Asian countries, remains a source of debate. [ncbi.nlm.nih.gov]

Epidemiology Incidence Although NV is quite common, erythema induratum is rare other than in India, Hong Kong, and some areas of South Africa. [unboundmedicine.com]

Epidemiologically, erythema induratum is an extremely rare diagnosis. The disease has a female predominance of up to 90% ( Bolognia, Jorizzo, & Schaffer, 2012 ). There is no racial predilection. [nursingcenter.com]

[…] vessels TERMINOLOGY Synonyms Erythema induratum of Bazin, nodular vasculitis Definitions Granulomatous lobular panniculitis with vasculitis ETIOLOGY/PATHOGENESIS Infectious Agents Mycobacterium species, Brucella species, hepatitis C CLINICAL ISSUES Epidemiology [basicmedicalkey.com]

[…] induratum with a negative tuberculin test, the cause is often unknown but there have been case reports of an association of erythema induratum with infectious disorders caused by nocardia, Pseudomonas spp., Fusarium spp., hepatitis C, and hepatitis B. [ 1 ] Epidemiology [patient.co.uk]

[…] main content General Medicine HOME Diseases & Conditions HOME DISEASES & CONDITIONS DRUGS FOR THE PATIENT PATIENT HANDOUTS PT EXERCISES TOOLS PROCEDURES ALGORITHMS & CHARTS LAB TESTS CME/CE Roger P Holland, MD, PhD Reviewed 06/2022 BASICS DESCRIPTION EPIDEMIOLOGY [5minuteconsult.com]

Most common (86%) form of cutaneous TB (tuberculid) in Hong Kong found between 1993 and 2002 Predominant age: 13 to 66 years (mean 37 years) Predominant sex: female (80–90%) > male Etiology and Pathophysiology The morphologic, molecular, and clinical [unboundmedicine.com]

We review the characteristics of EIB and examine how the unique presentation of peripheral neuropathy may relate to the pathophysiology of this disease. [ncbi.nlm.nih.gov]

Pathophysiology Predisposing factors include abnormal amount of subcutaneous fat, thick ankles and abnormally poor arterial supply. Abnormal arterial supply causes low-grade ischemia of ankle region. [ipfs.io]

Pathophysiology[edit] Predisposing factors include abnormal amount of subcutaneous fat, thick ankles and abnormally poor arterial supply. Abnormal arterial supply causes low-grade ischemia of ankle region. [en.wikipedia.org]

[…] diseases and negative cultures and immunostains include the presence of a small number of bacilli that escape routine laboratory detection, early destruction of organisms, or a reaction to circulating M tuberculosis fragments.2 Regardless, until the pathophysiology [mdedge.com]

Safe sex precautions, including condom use Counsel regarding not sharing needles in order to prevent HIV or hepatitis C transmission. [unboundmedicine.com]

Rest Compression stockings should be worn to prevent edema and increase he... [5minuteconsult.com]

Can Be Treated (Centers for Disease Control and Prevention) Tuberculosis Facts - Testing for TB (Centers for Disease Control and Prevention) Tuberculosis Facts - You Can Prevent TB (Centers for Disease Control and Prevention) Tuberculosis: General Information [icdlist.com]

Rapidly find the answers you need with separate sections on diseases and disorders, differential diagnosis, clinical algorithms, laboratory results, and clinical preventive services, plus an at-a-glance format that uses cross-references, outlines, bullets [books.google.com]

How can Erythema Induratum be Prevented? Currently, there are no known methods to prevent the occurrence of Erythema Induratum. [dovemed.com]

1. Cho K, Lee D, Kim C. Erythema induratum of Bazin. Int. J. Dermatol. 1996;35:802–8.
2. Takahashi S, Negishi I, Tamura A, et al. The close association of lymphadenitis tuberculosa and erythema induratum of Bazin in Japanese patients. Dermatology. 2003;207:426–7.
3. Daher E, Silva G, Pinheiro H, et al. Erythema induratum of Bazin and renal tuberculosis: report of an association. Rev Inst Med Trop Sao Paulo. 2004;46(5):295-8.
4. Ramdial P, Calonje E, Sydney C, et al. Tuberculids as sentinel lesions of tuberculous epididymo-orchitis. J Cutan Pathol. 2007;34(11):830-6.
5. Sughimoto K, Nakano K, Gomi A, et al. Aortic valve stenosis associated with Bazin's disease. J Heart Valve Dis. 2007;16(2):212-3.
6. Inoue T, Fukumoto T, Ansai S, et al. Erythema induratum of Bazin in an infant after Bacille Calmette-Guerin vaccination. J Dermatol. 2006;33(4):268-72.
7. Varshney A, Goyal T. Incidence of various clinico-morphological variants of cutaneous tuberculosis and HIV concurrence: a study from the Indian subcontinent. Ann Saudi Med. 2011;31(2):134-9.
8. Teramura K, Fujimoto N, Nakanishi G, et al. Disseminated erythema induratum of Bazin. Eur J Dermatol. 2014;24(6):697–8.
9. Zakeri K, Oganesyan G, Lee RA, et al. Erythema induratum of Bazin presenting as peripheral neuropathy. Cutis. 2015;96(3):E1-4.
10. Prajapati V, Steed M, Grewal P, et al. Erythema induratum: case series illustrating the utility of the interferon-? release assay in determining the association with tuberculosis. J Cutan Med Surg. 2013;17(S1):S6-S11.
11. Angus J, Roberts C, Kulkarni K, et al. Usefulness of the QuantiFERON test in the confirmation of latent tuberculosis in association with erythema induratum. Br J Dermatol. 2007;157(6):1293-4.
12. Sim JH, Whang KU. Application of the QuantiFERON®-TB Gold test in Erythema Induratum. J Dermatolog Treat. 2014;25(3):260-3.
13. Segura S, Pujol RM, Trindade F, et al. Vasculitis in erythema induratum of Bazin: a histopathologic study of 101 biopsy specimens from 86 patients. J Am Acad Dermatol. 2008;59(5):839-51.
14. Mascaro J, Baselga E. Erythema induratum of Bazin. Dermatol. Clin. 2008;26:439-45.