Erythema induratum Bazin

Bazin 1861.

Bazin syndrome, Bazin`s disease, nodular tuberculid, nodular vasculitis, nodular vasculitis, nodular vasculitis, hypodermitis nodularis subacuta saltans (O'Leary), phlebitis nodularis, lipodermatosclerosis, vasculitis nodularis.

Hyperergic-allergic reaction of the small vessels.

• Females > males
• Preferring to younger age.
• The occurrence is associated with increased sensitivity to cold (acrocyanosis, livedo reticularis) and pyknic constitution.

Tubercle bacilli are transported haematogenously to the acras, where a hyperergic-allergic reaction occurs. The reaction is assumed to be an Id reaction against the tuberculid. However, an association with tuberculosis cannot always be confirmed. In this case, the clinical finding is termed "nodular vasculitis“. „Erythema induratum Bazin“ is only used if an association with tuberculosis can be established.

• Recurrent occurrence of dolent, erythematous-brownish, cutaneous and subcutaneous nodules and plaques. There may be central necrosis with melting.  Non-ulcerated nodules usually heal after 2-3 months, while ulcerated nodules often do not heal at all.

• Clinical.
• Tuberculin test.
• Quantiferon test.
• Dermatopathological findings.
• Mycobacteria detection from biopsy.

• To exclude systemic involvement:
• Thoracic X-ray or CT- chest.
• Sonography of abdomen and kidneys.
• Collection of sputum in the morning (fasting for at least 4 hrs.) on 3 consecutive days.
• Collection of urine in the morning (fasting for at least 4 hrs) on 3 consecutive days.
• Bronchoalveolar lavage (BAL).

Extremities (US > OS), gluteal, upper arms and pectoral.

Growth atrophy, perivascular inflammation, fibrosis, granulomatous vasculitis and lobular panniculitis.

Years of chronic recurrence. Course with eventual, scarred healing.

1. Segura S, Pujol RM, Trindade F , Requena L. Vasculitis in erythema induratum of Bazin: A histopathologic study of 101 biopsy specimens from 86 patients. Journal of the American Academy of Dermatology 2008;59:839-51.
2. Kim GW, Park HJ, Kim HS, Chin HW, Kim SH, Ko HC et al. Simultaneous occurrence of papulonecrotic tuberculid and erythema induratum in a patient with pulmonary tuberculosis. Pediatr Dermatol 2013;30:256-9.
3. Park YM, Hong JK, Cho SH , Cho BK. Concomitant lichen scrofulosorum and erythema induratum. Journal of the American Academy of Dermatology 1998;38:841-3.