[Skip to Navigation]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address Please contact the publisher to request reinstatement.
April 1997

Detection of Mycobacterium tuberculosis DNA in Lobular Granulomatous Panniculitis (Erythema Induratum-Nodular Vasculitis)

Author Affiliations

From the Departments of Dermatology (Drs Baselga, Barnadas, and de Moragas) and Microbiology (Drs Margall and Coll), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

Arch Dermatol. 1997;133(4):457-462. doi:10.1001/archderm.1997.03890400057008

Objective:  To determine, using polymerase chain reaction (PCR) amplification, if Mycobacterium tuberculosis complex DNA is present in the skin biopsy specimens of lobular granulomatous panniculitis.

Design:  A retrospective descriptive study.

Setting:  A university-based hospital.

Patients:  From the 65 patients included in the study, we examined 72 paraffin-embedded skin biopsy specimens with a histologic diagnosis of erythema induratum or nodular vasculitis. The biopsy specimens were from the histopathological archives of the Departments of Dermatology and Pathology of the Hospital de la Santa Creu i Sant Pau, Barcelona, Spain, from 1976 to 1994. Twenty-two biopsy specimens were excluded from the final analysis because we could not amplify the internal control.

Main Outcome Measures:  Detection of a 123—base pair fragment of the IS6110 insertion sequence specific for M tuberculosis complex.

Results:  The results of PCR amplification were positive for M tuberculosis complex DNA in 77% of the skin biopsy specimens. No significant difference could be detected with respect to the age of the patients, ulceration of the nodules, reactivity to purified protein derivative, abnormal results of a chest x-ray examination, personal and family history of tuberculosis, and PCR results. The presence and degree of necrosis on histologic examination were significantly higher in the PCR-positive group (P=.04). None of the following variables were associated with PCR results: presence of vasculitis, degree of granulomatous infiltrates, number of giant cells, and presence of well-organized granulomas.

Conclusions:  The DNA of M tuberculosis can be detected in a considerable number of skin biopsy specimens of lobular granulomatous panniculitis. None of the clinical and histologic variables evaluated could accurately predict the results of PCR amplification. Arch Dermatol. 1997;133:457-462