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.

• Inflammation

  Additional workup did not indicate any other conditions including latent tuberculosis. 1, 2 Fig 1: Healed lesions on the posterior aspect of leg Fig 2: Skin biopsy (subcutaneous fat): a- Inflammation of fat lobules; b- Inflammation of septae; c- Inflammation [chanrejournals.com]

  Both groups showed varying combinations and degrees of acute and chronic inflammation, coagulative and caseation-like necrosis, and granulomatous inflammation. [ncbi.nlm.nih.gov]

  The vasculitis is of the larger vessels with panniculitis - an inflammation involving subcutaneous fat and occasionally muscle, with or without vasculitis. [patient.co.uk]

  However, vaccine risks include complications, such as subcutaneous abscesses including EIB, localized or generalized cutaneous tuberculids, local inflammation, fever, and spread of TB to distant organs. [unboundmedicine.com]

  The exact cause is unknown but the patchy inflammation in the blood vessels and lymphatics in the deep dermis and subcutaneous fat appears to relate to a slowed circulation. [americandragon.com]

• Chills

  He denied systemic symptoms such as fevers, chills, or pulmonary or gastrointestinal symptoms. [nursingcenter.com]

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

  She reported minimal coughing and a 25-lb weight loss over the last year, but she denied night sweats, fever, or chills. Figure 1. Disseminated erythema induratum in a patient with a history of tuberculosis. [mdedge.com]

  Key symptoms include chest pain, chills, chronic cough, fatigue, fever, hemoptysis, night sweats, and weight loss. Individuals may also have abnormal chest radiography or a positive sputum smear or culture [14]. [cureus.com]

• Pathologist

  The pathologist examines the biopsy under a microscope. [dovemed.com]

  "Dermatopathology for the surgical pathologist: a pattern-based approach to the diagnosis of inflammatory skin disorders (part II).". Adv Anat Pathol 15 (6): 350-69. doi : 10.1097/PAP.0b013e31818b1ac6. [librepathology.org]

• Infertility

  CM Diagnosis Code Q78.9 Osteochondrodysplasia, unspecified 2016 2017 2018 2019 2020 2021 2022 2023 Billable/Specific Code POA Exempt Applicable To Chondrodystrophy NOS Osteodystrophy NOS Anovulatory cycle N97.0 ICD-10-CM Diagnosis Code N97.0 Female infertility [icd10data.com]

• 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]

• Intestinal Disease

  Intestinal exams. If the doctor suspects that the underlying cause is an inflammatory bowel disease such as ulcerative colitis or Crohn’s disease, he may recommend other tests, such as colonoscopy. [hickeysolution.com]

• Erythema

  Erythema Induratum of Bazin Nodular Vasculitis Currently, the terms erythema induratum of Bazin and nodular vasculitis are used as synonyms by most authors to describe the most common form of lobular panniculitis with vasculitis. [dermaamin.com]

  Erythema Induratum of Bazin is a topic covered in the 5-Minute Clinical Consult. [unboundmedicine.com]

  DISCUSSION Erythema induratum is synonymous with nodular vasculitis. [nursingcenter.com]

  Erythema nodosum and erythema induratum (nodular vasculitis): diagnosis and management. Dermatol Ther. 2010 Jul-Aug;23(4):320-7 2. C. Nirmala and A.H. Nagarajappa. Erythema induratum - A type of cutaneous tuberculosis. [chanrejournals.com]

  Therefore, erythema induratum/nodular vasculitis complex is classified into 2 variants: erythema induratum of Bazin type and nodular vasculitis or erythema induratum of Whitfield type. [emedicine.com]

• Ulcer

  Usually, subcutaneous nodules become adherent to the skin surface, ulcerate, and then heal with scarring. [dermaamin.com]

  The nodules may ulcerate with bluish borders, and cold weather may be the precipitating factor. [patient.co.uk]

  There are very few cases of EIB presenting as annular plaques.[3] Nodules generally ulcerate in EIB, but in this case, the nodules did not ulcerate. [e-ijd.org]

  2004 in Revista do Instituto de Medicina Tropical de Sao… Erythema induratum of Bazin is a disease that usually affects women, in whom erythematous subcutaneous nodules and plaques appear on the posterior part of the lower extremities, some of which ulcerate [semanticscholar.org]

  They break down to form small and multiple ulcers. Fresh crops of nodules appear in periphery of ulcer and ultimately break down. [ipfs.io]

• Skin Lesion

  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]

  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]

• Eruptions

  Papulonecrotic tuberculid occurs predominantly in young adults and is characterized by eruptions of necrotizing papules that heal with varioliform scars. [ncbi.nlm.nih.gov]

  The conditions in the complex are characterized by the sudden onset of a reddened macular, bullous, papular, or vesicular eruption, the characteristic lesion being the iris, bull's eye, or target lesion, which consists of a central papule with two or [medical-dictionary.thefreedictionary.com]

  Explore these free sample topics: -- The first section of this topic is shown below -- Basics Description Erythema induratum of Bazin (EIB) is a chronic, nodular eruption that usually occurs on the lower legs of otherwise heavyset women. [unboundmedicine.com]

• Subcutaneous Nodule

  Usually, subcutaneous nodules become adherent to the skin surface, ulcerate, and then heal with scarring. [dermaamin.com]

  On physical examination, multiple deep subcutaneous nodules were scattered on the bilateral lower extremities. There was a hyperpigmented patch overlying a crop of nodules on the left calf ( Figure 1 ). [nursingcenter.com]

  nodules and plaques appear on the posterior part of the lower extremities, some of which ulcerate. [semanticscholar.org]

  Subcutaneous nodule histology was compatible with erythema induratum of Bazin, and liver biopsy evidenced granulomatous hepatitis. [ncbi.nlm.nih.gov]

  Bazin disease - recurrent, hard, subcutaneous nodules that frequently break down and form necrotic ulcers, usually on the calves; lesions are sterile and probably a form of nodular vasculitis. [medical-dictionary.thefreedictionary.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]

• Headache

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

  […] procedural pneumonia 術後肺炎 7 Post procedural pulmonary embolism 肺塞栓症 7 Post stroke epilepsy 脳卒中後てんかん 7 Post stroke seizure 脳卒中後遺症 7 Post thrombotic retinopathy 血栓後網膜症 7 Post thrombotic syndrome 血栓後症候群 7 Post viral fatigue syndrome ポストウイルス性疲労症候群 7 Postictal headache [ikenori.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.

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]

We plan to continue the treatment for another 3 months, and follow-up the patient thereafter. During the course of treatment, no side-effects such as nausea and vomiting were observed. [journals.lww.com]

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]

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

[…] minus' sign Virchow -triad Use Parentheses water AND (cup OR glass) Add an asterisk (*) at end of a word to include word stems Neuro* will search for Neurology, Neuroscientist, Neurological, and so on Use quotes to search for an exact phrase "primary prevention [read.qxmd.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.