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BMC Infect Dis 2019 Jan 29;19(1):97. Epub 2019 Jan 29.

Department of Medicine, University of Calgary, Alberta, Canada.

Background: Erythema induratum of Bazin (EIB) - nodular vasculitis associated with Mycobacterium tuberculosis (TB) - and Tuberculosis-Associated Ocular Inflammation (TB-AOI) represent uncommon manifestations of TB. There is limited data and a lack of diagnostic and treatment standards for these conditions.

Methods: Eleven-year retrospective review of EIB and TB-AOI cases managed in a provincial TB program with prospective phone-based follow-up of anti-tubercular therapy (ATT) recipients. Read More

An Bras Dermatol 2018 Nov/Dec;93(6):887-889

Department of Dermatology and Venereology, Hospital Santo António dos Capuchos, Centro Hospitalar de Lisboa Central, Lisbon, Portugal.

Nodular vasculitis is an uncommon type of panniculitis. It was firstly associated to the infection by Mycobacterium tuberculosis and named erythema induratum of Bazin, however nowadays it has been associated with several other underlying disorders and it is better described as nodular vasculitis. Concerning its relationship with malignant conditions, there is only one reported case, in association with metastatic colon adenocarcinoma. Read More

SAGE Open Med Case Rep 2018 10;6:2050313X18804076. Epub 2018 Oct 10.

Toronto Regional Dermatology and Wound Healing Clinic, Mississauga, ON, Canada.

Although rare, erythema induratum is the most common entity presenting as lobular panniculitis with vasculitis. It is usually caused by a hypersensitivity reaction to , although other aetiologies have been reported. We present a case of a 73-year-old male with multiple recurring tender erythematous nodules on the backs of both calves and shins. Read More

Am J Dermatopathol 2018 Mar;40(3):e36-e37

Department of Dermatology, University of California, Irvine, Irvine, CA.

Erythema induratum (EI), or nodular vasculitis (NV), is a type of panniculitis that is often associated with vasculitis affecting various-sized veins, venules, and arteries in reaction to various causative factors. Historically, EI was highly linked to tuberculosis, but in 1946, Montgomery first proposed the term NV to describe cases of EI not associated with tuberculosis. Only 2 reports of NV associated with inflammatory bowel disease have been reported in the literature. Read More

Eur J Dermatol 2017 08;27(4):410-412

Department of Dermatology, Shiga University of Medical Science, Setatsukinowa, Otsu, Shiga 520-2192, Japan.

Australas J Dermatol 2017 Aug 1;58(3):e79-e82. Epub 2016 Jun 1.

Department of Dermatology, St Vincent's Hospital, Melbourne, Victoria, Australia.

Nodular vasculitis (NV) refers to a chronic relapsing lobular panniculitis that is thought to be a hypersensitivity reaction to antigenic triggers. While it is commonly associated with tuberculosis, in many cases no underlying cause is found and the condition is difficult to manage. Here, we report three patients with refractory idiopathic NV effectively treated with colchicine, leading to a significant improvement or complete resolution of their symptoms. Read More

New Microbes New Infect 2016 Mar 22;10:112-5. Epub 2016 Jan 22.

Hospital Vozandes, Ecuador; Unidad de Investigaciones en Biomedicina, Zurita & Zurita Laboratorios, Ecuador; Facultad de Medicina, Pontificia Universidad Católica del Ecuador, Ecuador.

We report the first case of recently characterized species M. monacense associated with chronic nodular vasculitis, infecting a young woman. This case represents the first isolation of M. Read More

Ann Dermatol 2015 Oct 2;27(5):605-7. Epub 2015 Oct 2.

Department of Dermatology, Chungnam National University School of Medicine, Daejeon, Korea.

Nodular vasculitis was introduced by Montgomery for cases of erythema induratum-like lesions that were not associated with tuberculosis. Nodular vasculitis has been associated with both nontuberculous infections and noninfectious conditions. However, there has been no report on the development of nodular vasculitis during tumor necrosis factor-α inhibitor treatment. Read More

Case Rep Dermatol 2015 May-Aug;7(2):141-5. Epub 2015 Jul 15.

Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva, Switzerland.

We report a case of tuberculous granulomatous panniculitis without vasculitis in an 87-year-old female patient with B-cell chronic lymphocytic leukaemia. One month after starting chemotherapy with chlorambucil and prednisone she presented superficial erythematous plaques on the anterior side of the left leg. Three weeks later erythematous painless deep nodules appeared on the left popliteal fossa and on the left thigh. Read More

J Cutan Med Surg 2013 Oct;17 Suppl 1:S6-S11

Background: The interferon-γ release assay (IGRA) is a novel method for detecting previous sensitization to tuberculosis (TB). Despite having several advantages over the tuberculin skin test (TST), including higher specificity and no influence from past bacille Calmette-Guérin (BCG) exposure, there are a limited number of reports describing its application in patients with erythema induratum (EI)/nodular vasculitis (NV), which is usually but not always related to TB.

Objectives: The aim of our case series was to evaluate the usefulness of the IGRA for determining a TB association in patients with EI/NV. Read More

G Ital Dermatol Venereol 2013 Aug;148(4):387-94

Anatomic Pathology Unit Gaetano Rummo General Hospital, Benevento, Italy -

Panniculitides encompass a great number of different entities; however, once a vasculitis has been detected histopathologically within the subcutaneous tissue, the differential diagnosis is mainly restricted to polyarteritis (panarteritis) nodosa (PAN), nodular vasculitis (NV), and Bazin's erythema induratum (EI). Patients with PAN may have the disease confined to the skin, but must be followed over a long period because many of them develop late systemic disease. The NV/EI group represents by far the most common type of lobular panniculitis with vasculitis; we prefer keeping the distinction between the two entities by underlining the equation NV positive tuberculin skin test = EI. Read More

G Ital Dermatol Venereol 2013 Aug;148(4):325-33

Department of Clinical and Surgical Diagnostic and Pediatric Sciences. Dermatology Clinic University of Pavia and IRCCS Policlinico San Matteo Pavia, Italy -

A clinical approach to the vexing problem of diagnosis of panniculitis is traced in this paper, in order to obtain from the clinical findings, history and laboratory data of the patient useful, detailed and precise information, essential to address dermatologists to a specific clinical diagnosis of panniculitis. This approach is created in the same way as when a dermatologist faces any other dermatological disease, be it inflammatory or neoplastic. A common behavior in case of panniculitis is in fact just to take an adequate biopsy and wait for the pathologist report. Read More

Sao Paulo Med J 2012 ;130(6):405-8

Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, Brazil.

Context: Erythema induratum of Bazin (EIB) is considered to be a tuberculid reaction and consists of recurrent painful nodules. The differential diagnosis includes diseases like nodular vasculitis, perniosis, polyarteritis nodosa and erythema nodosum.

Case Report: We report the case of a woman with EIB who developed Addison's disease during treatment with anti-tuberculosis drugs with good response to glucocorticoid replacement. Read More

J Dermatolog Treat 2014 Jun 19;25(3):260-3. Epub 2012 Sep 19.

Department of Dermatology, College of Medicine, Soonchunhyang University , Seoul , South Korea.

Erythema induratum (EI) was originally described by Ernest Bazin in 1861 as nodular lesions on the legs in association with tuberculosis (TB). A 33-year-old woman was referred to our hospital with tender ulcerative nodules on her legs. Skin biopsies revealed lobular inflammation of the subcutaneous fat with vasculitis. Read More

Australas J Dermatol 2012 May 7;53(2):141-4. Epub 2011 Mar 7.

Department of Dermatology, St Vincent's Hospital Melbourne, Melbourne, Victoria, Australia.

We report a chronic case of nodular vasculitis that responded to oral clofazimine 300 mg daily. The condition had previously responded to moderate dose oral prednisolone, 50 mg daily, but would recur with weaning. Multiple corticosteroid-sparing agents were trialled, however these were either ineffective or poorly tolerated. Read More

Case Rep Dermatol 2011 Sep 12;3(3):263-7. Epub 2011 Dec 12.

Department of Dermatology, Kitasato University School of Medicine, Sagamihara, Japan.

We present the case history of a 48-year-old male patient with Chlamydophila (Chlamydia) pneumoniae who developed a nodular vasculitis. He developed a cutaneous vasculitis with the onset of respiratory symptoms. The diagnosis of Chlamydophila pneumoniae infection was based on serology. Read More

Am J Dermatopathol 2012 May;34(3):325-9

Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Saga University, Japan.

We herein report a patient with erythema induratum/nodular vasculitis (EI/NV) associated with Crohn's disease (CD), which is considered to be a rare type of metastatic CD. A 54-year-old woman, who had a history of CD, presented with erythematous nodules on her legs. The histopathological features of the skin biopsy revealed a granulomatous, mixed septal and lobular panniculitis, which was characterized by many discrete epithelioid cell granulomas (necrobiotic/necrotizing-type and sarcoidal type), necrosis of the adipocytes, and granulomatous phlebitis in the muscular wall of a subcutaneous vein. Read More

Dermatol Ther 2010 Jul-Aug;23(4):320-7

Department of Pathology, University of Virginia Health System, Charlottesville, Virginia, USA.

Erythema nodosum is the most common type of panniculitis; it may be due to a variety of underlying infectious or otherwise antigenic stimuli. The pathogenesis remains to be elucidated, but both neutrophilic inflammation and granulomatous inflammation are implicated. Beyond treating underlying triggers, therapeutic options consist mainly of nonsteroidal anti-inflammatory drugs, symptomatic care, potassium iodide, and colchicine. Read More

Dermatol Online J 2010 Apr 15;16(4). Epub 2010 Apr 15.

University of California Davis, Sacramento, California, USA.

An 81-year-old woman with a history of renal cell carcinoma and years of slowly, progressively enlarging pulmonary nodules of uncertain etiology presented with several weeks of painful lower extremity nodules. A biopsy revealed changes consistent with nodular vasculitis. A purified protein derivative and QuantiFERON test were positive, favoring the diagnosis of erythema induratum of Bazin. Read More

J Clin Virol 2009 Apr 23;44(4):333-6. Epub 2009 Feb 23.

Gastroenterology and Hepatology Department, Centro Hospitalar Vila Nova de Gaia Vila Nova de Gaia, Portugal.

Erythema induratum, or nodular vasculitis, was initially described as a type of cutaneous tuberculosis. Currently, it is considered a multifactorial syndrome of lobular panniculitis of unknown cause. An association between erythema induratum and hepatitis C virus (HCV) has been suggested in previous reports. Read More

Dermatol Clin 2008 Oct;26(4):439-45, v

Department of Dermatology, Hospital Clínico and Barcelona University School of Medicine, Calle Villarroel 170, 08036 Barcelona, Spain.

Erythema induratum of Bazin is a chronic, nodular eruption that usually occurs on the lower legs of young women. It has been regarded as a manifestation of tuberculin hypersensitivity, a type of tuberculid occurring on the legs, whereas nodular vasculitis represents the nontuberculous counterpart. The number of reports of erythema induratum of Bazin is decreasing in most developed countries in accordance with the decreased incidence of tuberculosis. Read More

J Cutan Pathol 2008 Oct 4;35(10):941-6. Epub 2008 Aug 4.

Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY, USA.

Background: Lobular panniculitis encompasses lupus profundus, atypical lymphocytic lobular panniculitis, erythema induratum and subcutaneous Sweet's syndrome, while septal panniculitis includes erythema nodosum and fibrosing dermal processes of burn out necrobiosis lipoidica and morphea profundus. Panniculitis may represent a sign of systemic disease and/or a modified immune response to hematogenously disseminated antigen.

Methods: We describe 10 cases of sterile neutrophilic dominant lobular panniculitis that represented an id reaction to non-tuberculous stimuli. Read More

Clin Exp Dermatol 2007 Nov 24;32(6):761-2. Epub 2007 Aug 24.

J Heart Valve Dis 2007 Mar;16(2):212-3

NTT Kanto M.C., Shinagawa-ward, Tokyo, Japan.

Bazin's disease was first reported in 1861, and is described as erythema induratum or nodular vasculitis. The condition is seen occasionally in middle-aged women on the skin of the calf, and a relationship to a tuberculosis infection has been proposed. In the present patient, valvular lesions occurred simultaneously with Bazin's disease, with granulomatous changes being demonstrated by the aortic valve pathology. Read More

J Drugs Dermatol 2006 Nov-Dec;5(10):992-3

Skin Oncology Fellow, Skin Oncology Program, Department of Dermatology, Boston University School of Medicine, MA 02118, USA.

Mycophenolate mofetil is commonly used as a steroid-sparing agent effective in the management of erythema nodosum, idiopathic nodular panniculitis (Pfiefer-Weber-Christian disease), bullous pemphigoid, pemphigus vulgaris, and psoriasis. We report a case of nodular vasculitis responsive to mycophenolate mofetil. The clinical presentation, etiology, and management options for nodular vasculitis are discussed. Read More

Rev Med Interne 2007 Jun 8;28(6):416-9. Epub 2007 Mar 8.

Service de Médecine Interne, Pôle Santé République, 105, avenue de la République, 63000 Clermont-Ferrand, France.

Introduction: Nodular thrombophlebitis is septal hypodermitis characterised by vasculitis with vein thrombosis. It may indicate serious underlying disorders.

Exegesis: We present two cases of nodular superficial phlebitis, which revealed tuberculosis and sarcoidosis. Read More

Am J Dermatopathol 2007 Feb;29(1):32-43

Division of Dermatology, Albany Medical College, MC-81, Albany, NY 12208, USA.

Most biopsies of cutaneous vasculitis will exhibit a small vessel neutrophilic vasculitis [leukocytoclastic vasculitis (LCV)] that is associated with immune complexes on direct immunofluorescence examination or, less commonly, antineutrophilic cytoplasmic antibodies (ANCA) by indirect immunofluorescence testing. Is in uncommon for skin biopsy to reveal solely a neutrophilic arteritis signifying the presence of cutaneous polyarteritis nodosa or, if accompanied by significant lobular panniculitis, nodular vasculitis/erythema induratum. In other cases, cutaneous vascular damage (fibrinoid necrosis, muscular vessel wall disruption, or endarteritis obliterans) will be mediated by a nonneutrophilic inflammatory infiltrate. Read More

Int J Dermatol 2006 Nov;45(11):1337-40

Department of Dermatology, University of Limpopo, South Africa.

Background: Tuberculides are the result of immunologic reactions to hematogenously spread antigenic components of Mycobacterium tuberculosis. There are three recognized tuberculides--papulonecrotic tuberculide, erythema induratum of Bazin, and lichen scrofulosorum. In 1997, in Japan, Hara and coworkers reported five patients with what they called "nodular granulomatous phlebitis," which they proposed was a fourth type of tuberculide. Read More

Hautarzt 2007 Mar;58(3):237-40

Dermatologikum Hamburg, Stephansplatz 5, 20354 Hamburg.

A 66-year-old woman presented with erythematous nodules on both legs and told of a history of lymph node tuberculosis that had been treated with surgery and tuberculostatic therapy years before. A biopsy taken from a nodule showed nodular vasculitis. PCR for Mycobacterium tuberculosis-specific DNA on the paraffin-embedded tissue was positive. Read More

J Dtsch Dermatol Ges 2004 Mar;2(3):206-14; quiz 215

Dermatologische Abteilung der Krankenanstalt Rudolfstiftung, Juchgasse 25, A-1030 Wien.