Recovery of Mycobacterium tuberculosis DNA in biopsies of erythema induratum-results in a series of patients using an improved polymerase chain reaction technique

Abstract

patients was found to be high (16%), and was comparable with the rate reported by Cardinali et al. 3 (5%).Supporting the observations of Woo et al., our group recently described a case of severe psoriasis in a patient with CD that did not respond to specific therapies for psoriasis. 4 EmA was absent, and IgA and IgG AGA serum levels were not raised. Diagnosis of CD was performed by jejunal biopsy, which showed atrophy of the intestinal villi. A gluten-free diet (GFD) was started, with rapid improvement of the duodenal mucosa and skin lesions. This case supports the association between CD and psoriasis, and the concept that psoriasis in CD patients can be improved by a GFD. This association was subsequently confirmed by Ojetti et al., 5 who showed a higher prevalence of CD in psoriatic patients than in controls.However, we are partially in disagreement with the authors on the correlation between CD-associated antibody positivity in psoriatic patients and greater disease activity. In our study we described a case of severe psoriasis in a CD patient with IgA and IgG AGA and EmA negativity. On this basis, we cannot affirm that CD-associated antibodies, in particular IgA and IgG AGA and TGA, have a predictive role for the presence of severe psoriasis in patients with CD.

Erythema Induratum: Case Series Illustrating the Utility of the Interferon-γ Release Assay in Determining the Association with Tuberculosis

“…8,11,12 Several associations have been reported in the medical literature, with TB being, by far, the most commonly implicated trigger. 3,13 However, demonstrating the relationship between EI/NV and an underlying TB infection remains challenging as AFB stains and Mycobacterium tuberculosis cultures of skin biopsy specimens are usually negative and evidence of active systemic TB is rarely present. 10 Furthermore, although granulomatous inflammation on routine histopathology and positive TST results are common findings in patients with EI/NV, the former is not specific for M. tuberculosis infection, although it has been argued that the latter simply reflects previous exposure to M. tuberculosis and does not prove active infection.…”

“…Several studies have investigated PCR as a method to detect M. tuberculosis deoxyribonucleic acid (DNA) in skin biopsy specimens of EI/NV. 8,[12][13][14][15][16][17][18][19][20] The reported rates of positivity in the five largest studies were 0% (0/20), 14 14% (9 of 65), 12 25% (5 of 20), 13 75% (9 of 12), 15 and 77% (40 of 52). 16 Possible explanations for the inconsistent results included different PCR assays and geographic variation of TB frequency.…”

Erythema induratum of Bazin induced by tuberculin skin test

“…The relationship between erythema induratum of Bazin (EIB) and Mycobacterium tuberculosis (MTB) remains controversial. The use of polymerase chain reaction (PCR) to recover MTB DNA from skin lesions has reactivated this discussion …”

Tuberculose cutanée et érythème induré de Bazin : étude rétrospective de 13 cas

“…L'hypothèse physiopathologique est celle d'une réaction d'hypersensibilité retardée au bacille tuberculeux ; celui-ci n'a jamais été isolé dans les lésions cutanées mais les investigations par PCR M. tuberculosis ont permis de suggérer la présence d'ADN tuberculeux dans ces lésions. Ainsi, une étude sur 65 biopsies cutanées d'EIB a montré une positivité de 14 % des prélèvements [14]. Dans une autre série de 20 biopsies, la PCR était positive dans 25 % des cas [15].…”