Cribier B, Grosshans E
Clinique Dermatologique, Faculté de médecine, Université Louis Pasteur, Strasbourg, France.
Ann Dermatol Venereol. 1990;117(12):937-43.
In 1855 Ernest Bazin, who had noted hard, deep and violaceous nodules on the legs of young women, created his famous "erythema induratum" classified among the "erythematous benign scrofulides". Some forty years later, identical lesions were observed associated with tuberculosis; Colcott-Fox called them "érythème induré de Bazin", and ever since that time erythema induratum has been presumed to be of tuberculous origin. In 1900, Darier spoke of "tuberculids" for erythema induratum, and Bazin's "scrofulides" were abusively translated as "tuberculids". In the early 20th century many authors described such skin lesions without any evidence of tuberculosis and later on many papers tried to deny this "systematic" association, but the idea that erythema induratum is caused by tuberculosis still lingers on in 1990. There are many arguments against a tuberculous aetiology, but although very few cases in large series are really associated with tuberculosis many patients have been treated with specific antituberculous agents. For numerous authors, erythema induratum in "tuberculous by definition". In 1945 Montgomery et al. created the "nodular vasculitis" concept. The clinical features are very similar to those of erythema induratum but the disease is certainly not of tuberculous origin. This new pathology has been well developed by French and Spanish authors (Bureau, Duperrat, Vilanova). Despite repeated efforts to separate these two "entities" no clinical or histological data are available to distinguish between erythema induratum and nodular vasculitis. The real meaning of "erythema induratum" is far from being clear: in old publications and sometimes in recent textbooks one can find the same name followed by of Bazin, Whitfield or Hutchinson. Some authors call the disease tuberculids, and other believe it is a true cutaneous tuberculosis.(ABSTRACT TRUNCATED AT 250 WORDS)
1855年,欧内斯特·巴赞注意到年轻女性腿部出现坚硬、深陷且呈紫罗兰色的结节,他创立了著名的“硬结性红斑”,并将其归类于“良性红斑性皮肤结核”。大约40年后,观察到相同的病变与结核病相关;科尔科特·福克斯称其为“巴赞硬结性红斑”,从那时起,硬结性红斑就被认为起源于结核。1900年,达里埃称硬结性红斑为“结核疹”,巴赞的“皮肤结核”被错误地翻译为“结核疹”。20世纪初,许多作者描述了此类皮肤病变,但并无结核病证据,后来许多论文试图否认这种“系统性”关联,但直到1990年,硬结性红斑由结核病引起的观点仍然存在。有许多反对结核病因的论据,尽管在大量病例中真正与结核病相关的很少,但许多患者已接受特异性抗结核药物治疗。对众多作者而言,硬结性红斑“从定义上就是结核性的”。1945年,蒙哥马利等人提出了“结节性血管炎”的概念。其临床特征与硬结性红斑非常相似,但该疾病肯定不是结核起源。法国和西班牙的作者(比罗、迪佩拉特、维拉诺瓦)对这一新病理进行了深入研究。尽管多次努力区分这两种“实体”,但尚无临床或组织学数据可区分硬结性红斑和结节性血管炎。“硬结性红斑”的真正含义远未明确:在旧出版物中,有时在近期教科书中,人们会看到后面跟着巴赞、惠特菲尔德或哈钦森名字的相同名称。一些作者称该疾病为结核疹,另一些人则认为它是一种真正的皮肤结核病。(摘要截取自250词)