Kuramoto Y, Aiba S, Tagami H
Department of Dermatology, Tohoku University School of Medicine, Japan.
J Am Acad Dermatol. 1990 Apr;22(4):612-6. doi: 10.1016/0190-9622(90)70082-s.
We report three cases of patients with erythema induratum of Bazin who showed extreme tuberculin hypersensitivity reactions and a good therapeutic response to isoniazid. In the first patient satellite lesions with epithelioid granuloma formation developed 3 weeks after injection of purified protein derivative. In the second patient a high fever developed 1 day after injection of purified protein derivative, and the third patient blistered at the injection site; the histopathologic pattern was similar to erythema multiforme. Immunohistologic study of the epithelioid granulomas demonstrated a predominance of Leu-1--bearing, Leu-3a--bearing, and human lymphocyte antigen-DR-expressing cells. We conclude that erythema induratum of Bazin represents a tuberculid caused by heightened delayed-type hypersensitivity to components of tubercle bacilli released from latent foci of infection.
我们报告了3例巴津硬红斑患者,这些患者表现出极强的结核菌素超敏反应,且对异烟肼治疗反应良好。在首例患者中,注射纯化蛋白衍生物3周后出现伴有上皮样肉芽肿形成的卫星病灶。在第二例患者中,注射纯化蛋白衍生物1天后出现高热,第三例患者在注射部位出现水疱;组织病理学模式类似于多形红斑。对上皮样肉芽肿的免疫组织学研究显示,主要为携带Leu-1、携带Leu-3a以及表达人类淋巴细胞抗原-DR的细胞。我们得出结论,巴津硬红斑是一种结核疹,由对潜伏感染灶释放的结核杆菌成分的迟发型超敏反应增强所致。