Dharmadji Hartati Purbo, Suwarsa Oki, Sutedja Endang, Pangastuti Miranti, Gunawan Hendra, Makarti Kristina
Department of Dermatology and Venereology, Faculty of Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin Hospital, Bandung, Indonesia.
Int Med Case Rep J. 2021 Nov 15;14:777-781. doi: 10.2147/IMCRJ.S336088. eCollection 2021.
Erythema induratum of Bazin (EIB) is a predominantly lobular panniculitis with or without vasculitis due to (MTB) infection. Atrophic scars may remain after EIB was healed. Rare cases of EIB showing sharp skin depression may mimic deep morphea and lupus profundus. A rare case of EIB was reported in a 35-year-old female with slightly tender erythematous-violaceous nodules and hyperpigmented depressed scars on both lower legs, resulting in asymmetrical lower leg shape. Histopathological examination showed lobular panniculitis without vasculitis and granulomatous inflammation consisted of caseous necrosis, epithelioid cells, and multinucleated giant cells. Polymerase chain reaction (PCR) from skin biopsy revealed deoxyribonucleic acid (DNA) of MTB. Tuberculin skin test (TST) was positive with a 20-mm induration, and nuclear 99mTc-ethambutol scintigraphy was positive for tuberculosis infection in one-third distal portion of the left lower leg. Clinical improvements were shown after 6 months of antituberculosis therapy. EIB must be considered in patient with erythematous-violaceous nodules on lower leg, especially in endemic areas of tuberculosis infection since diagnosis can be difficult and occasionally, deceptive.
巴津硬红斑（EIB）是一种主要为小叶性脂膜炎，可伴有或不伴有因结核分枝杆菌（MTB）感染引起的血管炎。EIB愈合后可能会留下萎缩性瘢痕。罕见的EIB病例出现明显的皮肤凹陷，可能类似深部硬斑病和深部狼疮。本文报道了1例35岁女性的罕见EIB病例，其双下肢出现轻度压痛的红紫色结节及色素沉着性凹陷瘢痕，导致双下肢形状不对称。组织病理学检查显示小叶性脂膜炎，无血管炎，肉芽肿性炎症由干酪样坏死、上皮样细胞和多核巨细胞组成。皮肤活检的聚合酶链反应（PCR）检测显示存在MTB的脱氧核糖核酸（DNA）。结核菌素皮肤试验（TST）硬结为20 mm，呈阳性，99mTc-乙胺丁醇核素显像显示左下肢远端三分之一处存在结核感染阳性。抗结核治疗6个月后临床症状改善。对于小腿出现红紫色结节的患者，尤其是在结核感染流行地区，必须考虑EIB，因为其诊断可能困难，且偶尔具有迷惑性。
