FC061 Tuberculosis verrucosa cutis, erythema induratum and P.C.R.

Diaz, C; Cucurell, M; Jeremias, Jan; Barranco, Charles; Carrato, Cristina; Escribano, G; Camarasa, J. G.

doi:10.1016/s0926-9959(97)89381-6

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“…The histopathologic features are heterogeneous and include necrotizing vasculitis, granulomatous infiltration, with caseation necrosis 5,17,20,28 . The detection of the bacilli through PCR technique strongly suggests the tuberculous etiology of this disease 2,6,11,12,24,26,29 . The PCR has a sensitivity of 98% and specificity of 100%, being an excellent method for the diagnosis of EIB, but has the disadvantage of being expensive 21 .…”

Section: Discussionmentioning

confidence: 99%

“…The Mycobacterium tuberculosis has been hardly detected in the cutaneous lesions, so that this association has been refuted for a long time 5,14,22 . Many recent studies have found genetic material of M. tuberculosis by polymerase chain reaction (PCR) in the samples of cutaneous lesions, suggesting the tuberculous etiology of EIB 2,6,11,12,24,26,29 .…”

Section: Introductionmentioning

confidence: 99%

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Erythema induratum of Bazin and renal tuberculosis: report of an association

Daher

Júnior

Pinheiro

et al. 2004

Rev. Inst. Med. trop. S. Paulo

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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. 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. These tend to involute, but new crops appear at irregular intervals. It was painful, erythematous-violaceous nodules, some of which drained a reddish secretion. The histopathologic features of the lesions demonstrated inflammatory infiltration, with predominance of neutrophils in dermis and hypodermis, necrotizing vasculitis in the arterioles and septal fibrosis. There was no granuloma. The Ziehl-Neelsen stain did not revealed acid-fast bacilli, and the culture of biopsy specimen was negative. The tuberculin skin test was strongly positive (17 mm). The chest X-ray was normal. Few months later she presented adynamia and urinary complaints, such as polacyuria and dysuria. 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. The urine culture for M. tuberculosis was positive in two out of ten samples. The treatment was instituted with rifampin, isoniazid and pyrazinamide, with complete regression. This case illustrates a clear association between erythema induratum and renal tuberculosis, demonstrated by the remission of the cutaneous lesions after the treatment of the renal tuberculosis.

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