Guillet Carole, Hauser Xenia, Stillhard Andrea, Schmid-Grendelmeier Peter, Kolm Isabel
Department of Dermatology, University Hospital Zurich, Zurich, Switzerland,
Department of Dermatology, University Hospital Zurich, Zurich, Switzerland.
Dermatology. 2025;241(1):27-34. doi: 10.1159/000542488. Epub 2024 Nov 18.
Nodular vasculitis (NV) is a rare form of panniculitis primarily affecting middle-aged females, presenting as painful, sometimes ulcerated nodules on the dorsal lower legs. Erythema induratum of Bazin (EIB) is a form of NV and is considered a manifestation of cutaneous tuberculin hypersensitivity. This retrospective study aims to analyze demographics, clinicopathological findings, laboratory results, and treatment outcomes of NV in a non-TB endemic country.
Data of NV patients were extracted from the electronic hospital database of the University Hospital Zurich. Patients were included only if histopathologically confirmed diagnosis of NV and sufficient information on demographics, treatment, and follow-up were available.
We conducted a 20-year retrospective study, including 62 patients with NV. The most common site of involvement was the lower extremities. Disease duration varied from several months to over 20 years. Histopathological examination revealed lobular panniculitis, with or without vasculitis, and granuloma formation. Tuberculosis association was assessed through the QuantiFERON test and mycobacteria PCR, showing positive results in 22 or 37 (59%) tested cases and in 2 out of 27 cases (7.4%), respectively. Comorbidities were found in over half of the patients. Treatment modalities included topical corticosteroids, antitubercular therapy, systemic steroids, and potassium iodide. Almost 50% of all patients experienced relapses despite treatment.
Topical steroids, antitubercular therapy, systemic steroids, and potassium iodide showed similar response rates. Tuberculostatic therapy upon detecting latent TB is recommended. Considering the high recurrence rate and potential side effects of systemic therapies, we recommend first-line treatment with potent topical steroids and compression stockings.
Nodular vasculitis (NV) is a rare form of panniculitis primarily affecting middle-aged females, presenting as painful, sometimes ulcerated nodules on the dorsal lower legs. Erythema induratum of Bazin (EIB) is a form of NV and is considered a manifestation of cutaneous tuberculin hypersensitivity. This retrospective study aims to analyze demographics, clinicopathological findings, laboratory results, and treatment outcomes of NV in a non-TB endemic country.
Data of NV patients were extracted from the electronic hospital database of the University Hospital Zurich. Patients were included only if histopathologically confirmed diagnosis of NV and sufficient information on demographics, treatment, and follow-up were available.
We conducted a 20-year retrospective study, including 62 patients with NV. The most common site of involvement was the lower extremities. Disease duration varied from several months to over 20 years. Histopathological examination revealed lobular panniculitis, with or without vasculitis, and granuloma formation. Tuberculosis association was assessed through the QuantiFERON test and mycobacteria PCR, showing positive results in 22 or 37 (59%) tested cases and in 2 out of 27 cases (7.4%), respectively. Comorbidities were found in over half of the patients. Treatment modalities included topical corticosteroids, antitubercular therapy, systemic steroids, and potassium iodide. Almost 50% of all patients experienced relapses despite treatment.
Topical steroids, antitubercular therapy, systemic steroids, and potassium iodide showed similar response rates. Tuberculostatic therapy upon detecting latent TB is recommended. Considering the high recurrence rate and potential side effects of systemic therapies, we recommend first-line treatment with potent topical steroids and compression stockings.
结节性血管炎（NV）是脂膜炎的一种罕见形式，主要影响中年女性，表现为小腿背侧疼痛、有时溃疡的结节。巴赞硬红斑（EIB）是NV的一种形式，被认为是皮肤结核菌素超敏反应的一种表现。这项回顾性研究旨在分析一个非结核病流行国家中NV患者的人口统计学特征、临床病理表现、实验室检查结果及治疗效果。
从苏黎世大学医院的电子医院数据库中提取NV患者的数据。仅纳入经组织病理学确诊为NV且有足够的人口统计学、治疗及随访信息的患者。
我们进行了一项为期20年的回顾性研究，纳入62例NV患者。最常受累部位是下肢。病程从数月到20多年不等。组织病理学检查显示小叶性脂膜炎，伴或不伴血管炎及肉芽肿形成。通过结核感染T细胞检测（QuantiFERON试验）和分枝杆菌聚合酶链反应评估与结核的关联，分别在37例检测病例中的22例（59%）以及27例中的2例（7.4%）显示阳性结果。超过半数患者存在合并症。治疗方式包括外用糖皮质激素、抗结核治疗、全身用糖皮质激素及碘化钾。尽管接受了治疗，几乎50%的患者出现复发。
外用糖皮质激素、抗结核治疗、全身用糖皮质激素及碘化钾显示出相似的有效率。建议在检测到潜伏性结核时进行抗痨治疗。考虑到全身治疗的高复发率及潜在副作用，我们建议一线治疗采用强效外用糖皮质激素及弹力袜。
结节性血管炎（NV）是脂膜炎的一种罕见形式，主要影响中年女性，表现为小腿背侧疼痛、有时溃疡的结节。巴赞硬红斑（EIB）是NV的一种形式，被认为是皮肤结核菌素超敏反应的一种表现。这项回顾性研究旨在分析一个非结核病流行国家中NV患者的人口统计学特征、临床病理表现、实验室检查结果及治疗效果。
从苏黎世大学医院的电子医院数据库中提取NV患者的数据。仅纳入经组织病理学确诊为NV且有足够的人口统计学、治疗及随访信息的患者。
我们进行了一项为期20年的回顾性研究，纳入62例NV患者。最常受累部位是下肢。病程从数月到20多年不等。组织病理学检查显示小叶性脂膜炎，伴或不伴血管炎及肉芽肿形成。通过结核感染T细胞检测（QuantiFERON试验）和分枝杆菌聚合酶链反应评估与结核的关联，分别在37例检测病例中的22例（59%）以及27例中的2例（7.4%）显示阳性结果。超过半数患者存在合并症。治疗方式包括外用糖皮质激素、抗结核治疗、全身用糖皮质激素及碘化钾。尽管接受了治疗，几乎50%的患者出现复发。
外用糖皮质激素、抗结核治疗、全身用糖皮质激素及碘化钾显示出相似的有效率。建议在检测到潜伏性结核时进行抗痨治疗。考虑到全身治疗的高复发率及潜在副作用，我们建议一线治疗采用强效外用糖皮质激素及弹力袜。
