The tuberculous origin of erythema induratum (El), a chronic nodular eruption of the lower legs, has long remained circumstantial, since Mycobacteria cannot be cultured from lesional specimens. Erythema induratum is characterized by painful, erythematous, sometimes ulcerating nodules on the lower legs that, histopathologically, show a lobular panniculitis. The exact diagnosis is obscured by the fact that a number of pathologic processes can cause a similar clinical picture, eg, perniones or lupus erythematosus. Even if an association with tuberculosis is assumed, the decision to start antituberculosis chemotherapy cannot be based on the diagnostic criteria required for the diagnosis of tuberculosis, eg, culture and microscopic detection of acid-fast bacilli. We describe a patient with El in whom the diagnosis of tuberculosis could be established by the detection of mycobacterial DNA in a lesional biopsy specimen using the polymerase chain reaction (PCR).
Report of a Case.
A 63-year-old white woman presented with a
Degitz K, Messer G, Schirren H, Meurer M. Successful Treatment of Erythema Induratum of Bazin Following Rapid Detection of Mycobacterial DNA by Polymerase Chain Reaction. Arch Dermatol. 1993;129(12):1619-1620. doi:10.1001/archderm.1993.04540010097017